Cyclic di-nucleotide induction of type i interferon

ABSTRACT

Methods and compositions are provided for increasing the production of a type I interferon (IFN) in a cell. Aspects of the methods include increasing the level of a 2′-5′ phosphodiester linkage comprising cyclic-di-nucleotide in a cell in a manner sufficient to increase production of the type I interferon (IFN) by the cell. Also provided are compositions and kits for practicing the embodiments of the methods.

CROSS REFERENCE TO RELATED APPLICATIONS

Under 35 U.S.C. §119(e), this application claims priority to the filingdate of U.S. Provisional Patent Application Ser. No. 61/819,499, filedon May 3, 2013; the disclosure of which applications are incorporatedherein by reference.

GOVERNMENT RIGHTS

This invention was made with government support under grant nos.A1063302, A1075038, A1080749, A1082357, and OD008677 awarded by theNational Institutes of Health. The government has certain rights in theinvention.

INTRODUCTION

Interferons (also referred to as “IFN” or “IFNs”) are proteins having avariety of biological activities, some of which are antiviral,immunomodulating and antiproliferative. They are relatively small,species-specific, single chain polypeptides, produced by mammalian cellsin response to exposure to a variety of inducers such as viruses,polypeptides, mitogens and the like. Interferons protect animal tissuesand cells against viral attack and are an important host defensemechanism. In most cases, interferons provide better protection totissues and cells of the kind from which they have been produced than toother types of tissues and cells, indicating that human-derivedinterferon could be more efficacious in treating human diseases thaninterferons from other species. Interferons may be classified as Type-I,Type-II and Type-Ill interferons. Mammalian Type-I interferons includeIFN-α (alpha), IFN-β (beta), IFN-κ (kappa), IFN-δ (delta), IFN-ε(epsilon), IFN-τ (tau), IFN-ω(omega), and IFN-ζ (zeta, also known aslimitin).

Agents that induce interferon production find use as vaccine adjuvantsand in formulations that initiate effector and memory T-cell responses.Effective adjuvants enhance specific immune responses to antigens whileminimizing toxic side effects, reducing the dose and dosage ofvaccinations, and broadening the immune response. There remains a needfor effective adjuvants that may be coformulated with antigens derivedfrom intracellular pathogens and cancer cells to activate an effectivecellular and humoral immune response to treat intracellular pathogensand reduce tumor burden. The immunomodulatory activity of interferonproteins, and the signaling pathways that regulate interferonproduction, are drawing interest as a target for designing newadjuvants.

Interferons have potential in the treatment of a large number of humancancers since these molecules have anti-cancer activity that acts atmultiple levels. First, interferon proteins can directly inhibit theproliferation of human tumor cells. The anti-proliferative activity isalso synergistic with a variety of approved chemotherapeutic agents suchas cisplatin, 5FU and paclitaxel. Secondly, the immunomodulatoryactivity of interferon proteins can lead to the induction of ananti-tumor immune response. This response includes activation of NKcells, stimulation of macrophage activity and induction of MHC class Isurface expression, leading to the induction of anti-tumor cytotoxic Tlymphocyte activity. In addition, interferons play a role incross-presentation of antigens in the immune system. Moreover, somestudies further indicate that IFN-β protein may have anti-angiogenicactivity. Angiogenesis, new blood vessel formation, is critical for thegrowth of solid tumors. Evidence indicates that IFN-β may inhibitangiogenesis by inhibiting the expression of pro-angiogenic factors suchas bFGF and VEGF. Lastly, interferon proteins may inhibit tumorinvasiveness by modulating the expression of enzymes, such ascollagenase and elastase, which are important in tissue remodeling.

Interferons also appear to have antiviral activities that are based ontwo different mechanisms. For instance, type I interferon proteins (αand β) can directly inhibit the replication of human hepatitis B virus(“HBV”) and hepatitis C virus (“HCV”), but can also stimulate an immuneresponse that attacks cells infected with these viruses.

SUMMARY

Methods and compositions are provided for increasing the production of atype I interferon (IFN) in a cell. Aspects of the methods includeincreasing the level of a 2′-5′ phosphodiester linkage comprisingcyclic-di-nucleotide in a cell in a manner sufficient to increaseproduction of the type I interferon (IFN) by the cell. Also provided arecompositions and kits for practicing the subject methods.

In one aspect, provided herein is a method for increasing the productionof a type I interferon (IFN) in a cell by increasing the level of a2′-5′ phosphodiester linkage containing cyclic-di-nucleotide in the cellin a manner sufficient to increase production of the type I interferon(IFN) by the cell.

In certain embodiments, the method includes the step of contacting thecell with the cyclic-di-nucleotide. In certain embodiments, thecyclic-di-nucleotide has two 2′-5′ phosphodiester linkages. In otherembodiments, the cyclic-di-nucleotide has a 2′-5′ phosphodiester linkageand a 3′-5′ phosphodiester linkage.

In certain embodiments, the cyclic-di-nucleotide comprises a guanosinenucleoside. In some embodiments, the cyclic-di-nucleotide contains twoguanosine nucleosides. In certain embodiments, the cyclic-di-nucleotidecomprises an adenosine nucleoside. In some embodiments, thecyclic-di-nucleotide contains two adenosine nucleosides. In otherembodiments, the cyclic-di-nucleotide comprises an adenosine nucleosideand a guanosine nucleoside.

In certain embodiments, the cyclic-di-nucleotide has the followingformula:

wherein X and Y are each:

In some embodiments, the cyclic-di-nucleotide has the following formula:

In certain embodiments of the method, the level of thecyclic-di-nucleotide is increased by increasing the activity of a cGAMPsynthase (cGAS) in the cell. In some embodiments, the activity of thecGAS is increased by enhancing expression of a nucleic acid encodingcGAS. In some embodiments, the activity of the cGAS is increased byintroducing a nucleic acid encoding the cGAS into the cell.

In certain embodiments, the method is for increasing the production ofinterferon (IFN) alpha. In other embodiments, the IFN is interferonbeta.

In certain embodiments, the method is for increasing the production of atype I interferon (IFN) in a mammalian cell. In particular embodiments,mammalian cell is a human cell. In some embodiments, the cell is invitro. In other embodiments, the cell is in vivo.

In another aspect, provided herein is a method for increasing theproduction of a type I interferon (IFN) in a subject, the methodincludes the step of administering to the subject an amount of a 2′-5′phosphodiester linkage comprising cyclic-di-nucleotide active agenteffective to increase the production of the type I interferon in thesubject.

The active agent can include, but is not limited to, any of the 2′-5′phosphodiester linkage containing cyclic-di-nucleotides describedherein. In certain embodiments, the cyclic-di-nucleotide has two 2′-5′phosphodiester linkages. In other embodiments, the cyclic-di-nucleotidehas a 2′-5′ phosphodiester linkage and a 3′-5′ phosphodiester linkage.

In some embodiments, the cyclic-di-nucleotide contains a guanosinenucleoside. In certain embodiments, the cyclic-di-nucleotide containstwo guanosine nucleosides. In some embodiments, the cyclic-di-nucleotidecontains an adenosine nucleoside. In specific embodiments, thecyclic-di-nucleotide contains two adenosine nucleosides. In otherembodiments, the cyclic-di-nucleotide contains an adenosine and aguanosine nucleoside. In some embodiments, the cyclic-di-nucleotide hasthe following formula:

wherein X and Y are each:

In some embodiments of the subject method, the cyclic-di-nucleotide hasthe following formula:

In certain embodiments, the 2′-5′ phosphodiester linkage comprisingcyclic-di-nucleotide active agent includes an agent that increasescellular activity of a cGAMP synthase (cGAS). In specific embodiments,the agent comprises a nucleic acid encoding the cGAS.

In certain embodiments, the method is for increasing the production ofinterferon (IFN) alpha in a subject. In other embodiments, the method isfor increasing the production of interferon beta in a subject.

In certain embodiments, the subject has a viral infection. In certainembodiments, the subject has a bacterial infection. In otherembodiments, the subject has a neoplastic disease. In certainembodiments, the subject is mammal. In some embodiments, the mammal is ahuman.

In another aspect, provided herein is a method for increasing astimulator of interferon genes (STING) mediated response in a subject,the method includes the step of administering to the subject an amountof a STING active agent effective to increase a STING mediated responsein the subject. In certain embodiments, the STING mediated response isnon-responsive to a cyclic-di-nucleotide having two 3′-5′ phosphodiesterbonds.

The STING active agent can include, but is not limited to, any of the2′-5′ phosphodiester linkage containing cyclic-di-nucleotides describedherein. In certain embodiments, the cyclic-di-nucleotide has two 2′-5′phosphodiester linkages. In other embodiments, the cyclic-di-nucleotidehas a 2′-5′ phosphodiester linkage and a 3′-5′ phosphodiester linkage.

In some embodiments, the cyclic-di-nucleotide contains a guanosinenucleoside. In certain embodiments, the cyclic-di-nucleotide containstwo guanosine nucleosides. In some embodiments, the cyclic-di-nucleotidecontains an adenosine nucleoside. In specific embodiments, thecyclic-di-nucleotide contains two adenosine nucleosides. In otherembodiments, the cyclic-di-nucleotide contains an adenosine and aguanosine nucleoside. In some embodiments, the cyclic-di-nucleotide hasthe following formula:

wherein X and Y are each:

In some embodiments of the subject method, the cyclic-di-nucleotide hasthe following formula:

In certain embodiments, the STING active agent includes an agent thatincreases cellular activity of a cGAMP synthase (cGAS). In specificembodiments, the agent comprises a nucleic acid encoding the cGAS.

In certain embodiments, the STING active agent includes an agent thatincreases cellular activity of STING. In specific embodiments, the agentcomprises a nucleic acid encoding the STING.

In certain embodiments, the subject has a viral infection. In certainembodiments, the subject has a bacterial infection. In otherembodiments, the subject has a neoplastic disease. In certainembodiments, the subject is mammal. In some embodiments, the mammal is ahuman.

In another aspect, provided herein is a cyclic-di-nucleotide comprisinga 2′-5′ phosphodiester linkage. Such cyclic-di-nucleotides are useful,for example, in practicing the subject methods, including, but notlimited to, methods for increasing the production of a type I interferonin a cell or a subject.

In certain embodiments, the cyclic-di-nucleotide has two 2′-5′phosphodiester linkages. In other embodiments, the cyclic-di-nucleotidehas a 2′-5′ phosphodiester linkage and a 3′-5′ phosphodiester linkage.

In certain embodiments, the cyclic-di-nucleotide contains a guanosinenucleoside. In some embodiments, the cyclic-di-nucleotide contains twoguanosine nucleosides. In certain embodiments, the cyclic-di-nucleotidecontains an adenosine nucleoside. In some embodiments, thecyclic-di-nucleotide contains two adenosine nucleosides. In otherembodiments, the cyclic-di-nucleotide contains an adenosine and aguanosine nucleoside.

In some embodiments, the cyclic-di-nucleotide has the following formula:

wherein X and Y are each:

In certain embodiments, the cyclic-di-nucleotide has the followingformula:

In another aspect, provided herein is a composition containing a 2′-5′phosphodiester linkage containing cyclic-di-nucleotiden and apharmaceutically acceptable carrier.

In certain embodiments, the cyclic-di-nucleotide has two 2′-5′phosphodiester linkages. In other embodiments, the cyclic-di-nucleotidehas a 2′-5′ phosphodiester linkage and a 3′-5′ phosphodiester linkage.In certain embodiments of the composition, the cyclic-di-nucleotidecontains a guanosine nucleoside. In some embodiments, thecyclic-di-nucleotide contains two guanosine nucleosides. In certainembodiments, the cyclic-di-nucleotide contains an adenosine nucleoside.In some embodiments, the cyclic-di-nucleotide contains two adenosinenucleosides. In other embodiments, the cyclic-di-nucleotide contains anadenosine and a guanosine nucleoside.

In certain embodiments of the composition, the cyclic-di-nucleotide hasthe following formula:

wherein X and Y are each:

In certain embodiments of the composition, the cyclic-di-nucleotide hasthe following formula:

BRIEF DESCRIPTION OF THE FIGURES

The invention is best understood from the following detailed descriptionwhen read in conjunction with the accompanying drawings. It isemphasized that, according to common practice, the various features ofthe drawings are not to-scale. On the contrary, the dimensions of thevarious features are arbitrarily expanded or reduced for clarity.Included in the drawings are the following figures:

FIGS. 1A-1F show the variable responsiveness of human STING variants tocyclic-di-nucleotides maps to arginine 232. (A) THP-1 cells weretransduced with vectors encoding an shRNA targeting STING or a controlshRNA. Cells were then stimulated with cyclic-di-GMP (cdG), dsDNA,cyclic-di-AMP (cdA), poly-inosine:cytosine (pI:C), or Sendai Virus, andinduction of human interferon-β mRNA was assessed by quantitativereverse transcriptase PCR. (B) Western blotting confirmed that knockdownof STING was effective. (C) HEK293T cells were transfected with theindicated amounts of various mouse (m) or human (h) STING expressionplasmid and then stimulated 6 h later by transfection with synthetic cdG(5 μM). GT denotes the null 1199N allele of Sting from Goldenticket (Gt)mice. STING activation was assessed by use of a co-transfectedIFN-luciferase reporter construct. (D) Gt (STING-null) macrophages weretransduced with retroviral vectors encoding the indicated STING allelesand were then stimulated 48 h later by transfection with cdG (5 μM) ordsDNA 70-mer oligonucleotide (0.5 μg/mL). IFN induction was measured byqRT-PCR. ND, not detected. (E) Binding assay of STING to 32P-c-di-GMP.STING proteins were expressed in HEK293T cells and cell lysates weresubjected to UVcrosslinking with ³²P-cdG, and resolved by SDS-PAGE.Binding was quantified by autoradiography. Western blots of cell lysateswith an anti-STING polyclonal antibody confirmed similar expression ofthe various STING proteins. (F) Responsiveness of mSTING to cGAMP isaffected by mutations of R231. The indicated mutants were tested as inC.

FIG. 2 shows the sequence alignment of hSTING variants. hSTING wascloned from THP-1 cells compared to the reference STING allele (NCBINP_(—)938023.1).

FIG. 3 shows that R232 of human STING is required for responsiveness toc-di-GMP, but not for binding of c-di-GMP. (A) 293T cells weretransfected with the indicated alleles of mouse (m)STING or human(h)STING and were then stimulated with c-di-GMP (cdG). STING activitywas detected by the induction of a co-transfected IFN-luciferasereporter construct and expressed as fold-induction over luciferaseactivity of unstimulated cells. (B) Lysates of transfected 293T cellswere UV crosslinked in the presence of α32P-c-di-GMP, resolved bySDS-PAGE, and then analyzed by autoradiography. Lysates were alsowestern blotted for STING and ACTIN as expression controls in parallel.

FIG. 4 shows that G230A and H232R are both required for optimalresponsiveness to c-di-nucleotides but are not required for binding toc-di-nucleotides. (A, B) 293T cells were transfected with the indicatedalleles of mouse (m)STING or human (h)STING and were then stimulatedwith c-di-GMP (cdG). STING activity was detected by the induction of acotransfected IFN-luciferase reporter construct.

FIG. 5 shows that STING variants are responsive to cGAS. (A) HEK293Tcells were transfected with the indicated STING alleles and with humanand mouse cGAS (wt and GS>AA mutants) as indicated. STING activation wasassessed by a co-transfected IFN-luciferase reporter construct. (B)HEK293T cells were transfected with the indicated STING alleles and witha mammalian expression vector encoding a cGAMP synthase (DncV) from V.cholerae. STING activation was assessed as in A. (C) In vitroenzymatically generated products of rWspR, rDncV and rcGAS weretransfected into digitonin permeabilized HEK293T cells expressing theindicated mouse and human STING proteins. Chemically synthesizedcyclic-di-GMP (cdG) and cGAMP were included as controls. STINGactivation was assessed as in A and B.

FIG. 6 shows that cGAS produces a non-canonical cyclic dinucleotidecontaining a 2′-5′ phosphodiester linkage. (A) Purified recombinantWspR, DncV and cGAS were mixed with α³²P-GTP or α³²P-ATP and theindicated unlabeled nucleotides. Reactions were mixed with TLC runningbuffer and nucleic acid species were resolved on a PEI-Cellulose TLCplate. (B) WspR, DncV and cGAS products labeled with α³²P-GTP weredigested with nuclease P1 and Snake Venom Phosphodiesterase and nucleicacid species were resolved on a PEI-Cellulose TLC plate. (C) ¹H-³¹P HMBCof HPLC-purified cGAS product acquired at 600 MHz and 50° C. Criticalthrough-bond correlations for the phosphodiester bonds are indicated.NMR elucidated structure of cGAS product is also shown.

FIGS. 7A-7D provide additional NMR analysis of the cGAS product. Alldata acquisition was performed in D2O and at 50° C. (A, B)Multiplicity-edited 1H-13C HSQC experiment in a 900 MHz field. Positivephased signals corresponding to methine and methyl protons are shown ingreen, negative phased signals corresponding to methylene protons areshown in blue. (C) ¹H-¹H COSY experiment in a 600 MHz field. (D) ¹H-¹HNOESY experiment in a 900 MHz field.

DETAILED DESCRIPTION

Methods and compositions are provided for increasing the production of atype I interferon (IFN) in a cell. Aspects of the methods includeincreasing the level of a 2′-5′ phosphodiester linkage comprisingcyclic-di-nucleotide in a cell in a manner sufficient to increaseproduction of the type I interferon (IFN) by the cell. Also provided arecompositions and kits for practicing embodiments of the subject methods.

Before the present invention is described in greater detail, it is to beunderstood that this invention is not limited to particular embodimentsdescribed, as such may, of course, vary. It is also to be understoodthat the terminology used herein is for the purpose of describingparticular embodiments only, and is not intended to be limiting, sincethe scope of the present invention will be limited only by the appendedclaims.

Where a range of values is provided, it is understood that eachintervening value, to the tenth of the unit of the lower limit unlessthe context clearly dictates otherwise, between the upper and lowerlimit of that range and any other stated or intervening value in thatstated range, is encompassed within the invention. The upper and lowerlimits of these smaller ranges may independently be included in thesmaller ranges and are also encompassed within the invention, subject toany specifically excluded limit in the stated range. Where the statedrange includes one or both of the limits, ranges excluding either orboth of those included limits are also included in the invention.

Certain ranges are presented herein with numerical values being precededby the term “about.” The term “about” is used herein to provide literalsupport for the exact number that it precedes, as well as a number thatis near to or approximately the number that the term precedes. Indetermining whether a number is near to or approximately a specificallyrecited number, the near or approximating recited number may be a numberwhich, in the context in which it is presented, provides the substantialequivalent of the specifically recited number.

Unless defined otherwise, all technical and scientific terms used hereinhave the same meaning as commonly understood by one of ordinary skill inthe art to which this invention belongs. Although any methods andmaterials similar or equivalent to those described herein can also beused in the practice or testing of the present invention, representativeillustrative methods and materials are now described.

All publications and patents cited in this specification are hereinincorporated by reference as if each individual publication or patentwere specifically and individually indicated to be incorporated byreference and are incorporated herein by reference to disclose anddescribe the methods and/or materials in connection with which thepublications are cited. The citation of any publication is for itsdisclosure prior to the filing date and should not be constructed as anadmission that the present invention is not entitled to antedate suchpublication by virtue of prior invention. Further, the dates ofpublication provided may be different from the actual publication dateswhich may need to be independently confirmed.

It is noted that, as used herein and in the appended claims, thesingular forms “a”, “an”, and “the” include plural referents unless thecontext clearly dictates otherwise. It is further noted that the claimsmay be drafted to exclude any optional element. As such, this statementis intended to serve as antecedent basis for use of such exclusiveterminology as “solely,” “only” and the like in connection with therecitation of claim elements, or use of a “negative” limitation.

As will be apparent to those of skill in the art upon reading thisdisclosure, each of the individual embodiments described and illustratedherein has discrete components and features which may be readilyseparated from or combined with the features of any of the other severalembodiments without departing from the scope or spirit of the presentinvention. Any recited method can be carried out in the order of eventsrecited or in any other order which is logically possible.

Methods

As summarized above, methods of increasing the production of a type Iinterferon (IFN) in a cell, e.g., in vitro or in vivo are provided. Byincreasing type-I interferon production is meant that the subjectmethods increase type-I interferon production in a cell, as compared toa control. The magnitude of the increase may vary, and in some instancesis 2-fold or greater, such as 5-fold or greater, including 10-fold orgreater, as compared to a suitable control. As such, in some instances,the methods are methods of increasing type-I interferon production in acell, e.g., by a magnitude of 2-fold or greater, such as 5-fold orgreater, including 10-fold or greater, as compared to a suitablecontrol. In those embodiments where, prior to practice of the methods,interferon production is not-detectable, the increase may result indetectable amounts of interferon production. Interferon production canbe measured using any suitable method, including, but not limited to,vesicular stomatitis virus (VSV) challenge bioassay, enzyme-linkedimmunosorbent assay (ELISA) replicon based bioassays or by using areporter gene (e.g., luciferase) cloned under regulation of a Type Iinterferon signaling pathway. See, e.g., Meager J. Immunol. Methods261:21-36 (2002); Vrolijk et al. C. J. Virol. Methods 110:201-209(2003); and Francois et al. Antimicrob Agents Chemother 49(9):3770-3775(2005).

The methods may be used to increase the production of any type Iinterferon including, but not limited to: IFN-α (alpha), IFN-β (beta),IFN-κ (kappa), IFN-δ (delta), IFN-ε (epsilon), IFN-τ (tau), IFN-ω(omega), and IFN-ζ (zeta, also known as limitin). In some embodiments,the method is for increasing the production of IFN-α. In someembodiments, the method is for increasing IFN-β.

Aspects of the methods include increasing the level of a 2′-5′phosphodiester linkage comprising cyclic-di-nucleotide in a cell in amanner sufficient to increase production of the type I interferon by thecell. By increasing the level of a 2′-5′ phosphodiester linkagecomprising cyclic-di-nucleotide is meant that the subject methodsincrease the amount of a 2′-5′ phosphodiester linkage comprisingcyclic-di-nucleotide as compared to a control. As demonstrated in theExperimental Section below, 2′-5′ phosphodiester linkage comprisingcyclic-di-nucleotides can increase the levels of type I interferonproduction. The magnitude of the increase may vary, and in someinstances is 2-fold or greater, such as 5-fold or greater, including10-fold or greater, 15-fold greater, 20-fold greater, 25-fold greater,30-fold greater, 35-fold greater, 40-fold greater, 45-fold greater,50-fold greater, or 100 fold greater, as compared to a suitable control.

Increasing the level of a 2′-5′ phosphodiester linkage comprisingcyclic-di-nucleotide levels can be accomplished using a variety ofdifferent approaches. In some instances, the method includes providing atarget cell with a cyclic-di-nucleotide active agent that increases2′-5′ phosphodiester linkage comprising cyclic-di-nucleotide levels inthe target cell. Cyclic-di-nucleotide active agents may vary, andinclude, but are not limited to: small molecules, nucleic acid, protein,and peptide agents.

In some embodiments, the cyclic-di-nucleotide active agent increasesIFN-α (alpha), IFN-β (beta), IFN-κ (kappa), IFN-δ (delta), IFN-ε(epsilon), IFN-τ (tau), IFN-ω (omega), and/or IFN-ζ (zeta, also known aslimitin) in a cell or subject as compared to a control that has not beencontacted with the cyclic-di-nucleotide active agent. In suchembodiments, the increase is from 1.5-fold increase to 50-fold increaseor more, including 2-fold increase to 45-fold increase, 5-fold increaseto 40-fold increase, 10-fold increase to 35-fold increase, 15-foldincrease to 30-fold increase, 20-fold increase to 30-fold increase, andthe like.

In some instances, the cyclic-di-nucleotide active agent is a 2′-5′phosphodiester linkage containing cyclic-di-nucleotide or a functionalanalogue thereof. 2′-5′ phosphodiester linkage containingcyclic-di-nucleotide include, but are not limited to, those 2′-5′phosphodiester linkage containing cyclic-di-nucleotides describedherein.

As used herein “cyclic-di-nucleotide” refers to a compound containingtwo nucleosides (i.e., a first and second nucleoside), wherein the 2′ or3′ carbon of each nucleoside is linked to the 5′ carbon of the othernucleoside by a phosphodiester bond. Therefore, a 2′-5′ phosphodiesterlinkage containing cyclic-di-nucleotide refers to acyclic-di-nucleotide, wherein the 2′ carbon of at least the first orsecond nucleosides is linked to the 5′ carbon of the other nucleoside.2′-5′ phosphodiester linkage containing cyclic-di-nucleotide arediscussed in greater detail below.

Functional analogues of 2′-5′ phosphodiester linkage containingcyclic-di-nucleotides are those compounds that exhibit similarfunctional activity (e.g., increasing the production of a type I IFN)and may have a similar structure to a 2′-5′ phosphodiester linkagecontaining cyclic-di-nucleotide. In some instances, the functionalanalogue is a small molecule agent. Naturally occurring or syntheticsmall molecule compounds of interest include numerous chemical classes,such organic molecules, including small organic compounds having amolecular weight of more than 50 and less than about 2,500 daltons.Candidate agents comprise functional groups necessary for structuralinteraction with proteins, particularly hydrogen bonding, and typicallyinclude at least an amine, carbonyl, hydroxyl or carboxyl group,preferably at least two of the functional chemical groups. The candidateagents may comprise cyclical carbon or heterocyclic structures and/oraromatic or polyaromatic structures substituted with one or more of theabove functional groups. Candidate agents are also found amongbiomolecules including peptides, saccharides, fatty acids, steroids,purines, pyrimidines, derivatives, structural analogs or combinationsthereof. Such molecules may be identified, among other ways, byemploying suitable screening protocols.

In some instances, the cyclic-di-nucleotide active agent is an agentthat increases the cellular activity of a cyclic GMP-AMP synthase(cGAS). As discussed in the Experimental Section, below, increasing thelevels cGMP synthase (cGAS) can increase the production and/or activityof cyclic-di-nucleotide in a cell. As such, a target cell may becontacted with an agent that increases cGMP synthase production and/orcellular activity in a manner sufficient to increase the production ofType I interferon in the cell. In some embodiments, thecyclic-di-nucleotide active agent is a nucleic acid encoding a cGAS.Nucleic acids encoding various cGAS enzymes include, but are not limitedto, those described in: Sun et al. Science 339(6121):786-91 and thosedeposited in GENBANK and assigned deposit numbers: NM_(—)138441.2 andNP_(—)612450.2 (human); NM_(—)173386.4 and NP_(—)775562.2 (musmusculus).

In certain embodiments, the nucleic acid encoding cGAS has the followingsequence:

(SEQ ID NO: 01) agcctggggttccccttcgggtcgcagactcttgtgtgcccgccagtagtgcttggtttccaacagctgctgctggctcttcctcttgcggccttttcctgaaacggattcttctttcggggaacagaaagcgccagccatgcagccttggcacggaaaggccatgcagagagcttccgaggccggagccactgcccccaaggcttccgcacggaatgccaggggcgccccgatggatcccaccgagtctccggctgcccccgaggccgccctgcctaaggcgggaaagttcggccccgccaggaagtcgggatcccggcagaaaaagagcgccccggacacccaggagaggccgcccgtccgcgcaactggggcccgcgccaaaaaggcccctcagcgcgcccaggacacgcagccgtctgacgccaccagcgcccctggggcagaggggctggagcctcctgcggctcgggagccggctctttccagggctggttcttgccgccagaggggcgcgcgctgctccacgaagccaagacctccgcccgggccctgggacgtgcccagccccggcctgccggtctcggcccccattctcgtacggagggatgcggcgcctggggcctcgaagctccgggcggttttggagaagttgaagctcagccgcgatgatatctccacggcggcggggatggtgaaaggggttgtggaccacctgctgctcagactgaagtgcgactccgcgttcagaggcgtcgggctgctgaacaccgggagctactatgagcacgtgaagatttctgcacctaatgaatttgatgtcatgtttaaactggaagtccccagaattcaactagaagaatattccaacactcgtgcatattactttgtgaaatttaaaagaaatccgaaagaaaatcctctgagtcagtttttagaaggtgaaatattatcagcttctaagatgctgtcaaagtttaggaaaatcattaaggaagaaattaacgacattaaagatacagatgtcatcatgaagaggaaaagaggagggagccctgctgtaacacttcttattagtgaaaaaatatctgtggatataaccctggctttggaatcaaaaagtagctggcctgctagcacccaagaaggcctgcgcattcaaaactggctttcagcaaaagttaggaagcaactacgactaaagccattttaccttgtacccaagcatgcaaaggaaggaaatggtttccaagaagaaacatggcggctatccttctctcacatcgaaaaggaaattttgaacaatcatggaaaatctaaaacgtgctgtgaaaacaaagaagagaaatgttgcaggaaagattgtttaaaactaatgaaataccttttagaacagctgaaagaaaggtttaaagacaaaaaacatctggataaattctcttcttatcatgtgaaaactgccttctttcacgtatgtacccagaaccctcaagacagtcagtgggaccgcaaagacctgggcctctgctttgataactgcgtgacatactttcttcagtgcctcaggacagaaaaacttgagaattattttattcctgaattcaatctattctctagcaacttaattgacaaaagaagtaaggaatttctgacaaagcaaattgaatatgaaagaaacaatgagtttccagtttttgatgaattttgagattgtatttttagaaagatctaagaactagagtcaccctaaatcctggagaatacaagaaaaatttgaaaaggggccagacgctgtggctcac.

In some embodiments, the nucleic acid encoding cGAS is a nucleic acidwith 40% to 99%, 45% to 99%, 50% to 99%, 55% to 99%, 60% to 99%, 65% to99%, 70% to 99%, 75% to 99%, 80% to 99%, 85% to 99%, 90% to 99% or, 95%to 99% sequence identity with a wild type cGAS nucleic acid sequence. Insome embodiments, the nucleic acid encoding cGAS is a nucleic acid with40% to 50%, 50% to 60%, 60% to 70%, 70% to 80%, 80% to 90%, or 90 to 99%sequence identity with a wild type cGAS nucleic acid sequence. In someembodiments, the nucleic acid encoding cGAS is a nucleic acid with 40%or more, 45% or more, 50% or more, 55% or more, 60% or more, 70% ormore, 75% or more, 80% or more, 85% or more, 90% or more, 95% or more or99% or more sequence identity with a wild type cGAS nucleic acidsequence.

In some instances, the cyclic-di-nucleotide active agent is a vectorcontaining a nucleic acid encoding cGAS. Vectors may be provideddirectly to the subject cells. In other words, the cells are contactedwith vectors having the nucleic acid encoding the cyclic-di-nucleotideactive agent(s) (e.g., a nucleic acid encoding cGAS) such that thevectors are taken up by the cells. Methods for contacting cells withnucleic acid vectors that are plasmids, such as electroporation, calciumchloride transfection, and lipofection, are well known in the art. Forviral vector delivery, the cells are contacted with viral particlescomprising the nucleic acid encoding the cyclic-di-nucleotide agent(s).Retroviruses, for example, lentiviruses, are particularly suitable tothe method of the invention. Commonly used retroviral vectors are“defective”, i.e., unable to produce viral proteins required forproductive infection. Rather, replication of the vector requires growthin a packaging cell line. To generate viral particles comprising nucleicacids of interest, the retroviral nucleic acids comprising the nucleicacid are packaged into viral capsids by a packaging cell line. Differentpackaging cell lines provide a different envelope protein (ecotropic,amphotropic or xenotropic) to be incorporated into the capsid, thisenvelope protein determining the specificity of the viral particle forthe cells (ecotropic for murine and rat; amphotropic for most mammaliancell types including human, dog and mouse; and xenotropic for mostmammalian cell types except murine cells). The appropriate packagingcell line may be used to ensure that the cells are targeted by thepackaged viral particles. Methods of introducing the retroviral vectorscomprising the nucleic acid encoding the reprogramming factors intopackaging cell lines and of collecting the viral particles that aregenerated by the packaging lines are well known in the art.

Vectors used for providing the nucleic acids encoding thecyclic-di-nucleotide activity active agent(s) to the subject cells mayinclude suitable promoters for driving the expression, that is,transcriptional activation, of the nucleic acid of interest. In otherwords, the nucleic acid of interest will be operably linked to apromoter. This may include ubiquitously acting promoters, for example,the CMV-β-actin promoter, or inducible promoters, such as promoters thatare active in particular cell populations or that respond to thepresence of drugs such as tetracycline. By transcriptional activation,it is intended that transcription will be increased above basal levelsin the target cell by 10 fold or more, by 100 fold or more, by 1000 foldor more. In addition, vectors used for providing cyclic-di-nucleotideactive agent(s) to the subject cells may include nucleic acid sequencesthat encode for selectable markers in the target cells, so as toidentify cells that have taken up the cyclic-di-nucleotide activityactive agent(s).

Cyclic-di-nucleotide active agent(s) may also be provided to cells aspolypeptides. For example, in some instances the cyclic-di-nucleotideactive agent is a cGAS polypeptide. Amino acid sequences of various cGASenzymes include, but are not limited to, those described in: Sun et al.Science 339(6121):786-91 and those deposited in GENBANK and assigneddeposit numbers: NM_(—)138441.2 and NP_(—)612450.2 (human);NM_(—)173386.4 and NP_(—)775562.2 (mus musculus).

In certain embodiments, the cGAS polypeptide has the following sequence:

(SEQ ID NO: 02) MQPWHGKAMQRASEAGATAPKASARNARGAPMDPTESPAAPEAALPKAGKFGPARKSGSRQKKSAPDTQERPPVRATGARAKKAPQRAQDTQPSDATSAPGAEGLEPPAAREPALSRAGSCRQRGARCSTKPRPPPGPWDVPSPGLPVSAPILVRRDAAPGASKLRAVLEKLKLSRDDISTAAGMVKGVVDHLLLRLKCDSAFRGVGLLNTGSYYEHVKISAPNEFDVMFKLEVPRIQLEEYSNTRAYYFVKFKRNPKENPLSQFLEGEILSASKMLSKFRKIIKEEINDIKDTDVIMKRKRGGSPAVTLLISEKISVDITLALESKSSWPASTQEGLRIQNWLSAKVRKQLRLKPFYLVPKHAKEGNGFQEETWRLSFSHIEKEILNNHGKSKTCCENKEEKCCRKDCLKLMKYLLEQLKERFKDKKHLDKFSSYHVKTAFFHVCTQNPQDSQWDRKDLGLCFDNCVTYFLQCLRTEKLENYFIPEFNLFSSNLIDKRSKEFLTKQIEY ERNNEFPVFDEF. 

In some embodiments, the cGAS polypeptide is a polypeptide that has 40%to 99%, 45% to 99%, 50% to 99%, 55% to 99%, 60% to 99%, 65% to 99%, 70%to 99%, 75% to 99%, 80% to 99%, 85% to 99%, 90% to 99% or, 95% to 99%sequence identity with a wild type cGAS amino acid sequence. In someembodiments, the cGAS polypeptide is a polypeptide that has 40% to 50%,50% to 60%, 60% to 70%, 70% to 80%, 80% to 90%, or 90 to 99% sequenceidentity with a wild type cGAS amino acid sequence. In some embodiments,the cGAS polypeptide is a polypeptide that has 40% or more, 45% or more,50% or more, 55% or more, 60% or more, 70% or more, 75% or more, 80% ormore, 85% or more, 90% or more, 95% or more or 99% or more sequenceidentity with a wild type cGAS amino acid sequence.

Such polypeptides may optionally be fused to a polypeptide domain thatincreases solubility of the product. The domain may be linked to thepolypeptide through a defined protease cleavage site, e.g., a TEVsequence, which is cleaved by TEV protease. The linker may also includeone or more flexible sequences, e.g., from 1 to 10 glycine residues. Insome embodiments, the cleavage of the fusion protein is performed in abuffer that maintains solubility of the product, e.g., in the presenceof from 0.5 to 2 M urea, in the presence of polypeptides and/orpolynucleotides that increase solubility, and the like. Domains ofinterest include endosomolytic domains, e.g., influenza HA domain; andother polypeptides that aid in production, e.g., IF2 domain, GST domain,GRPE domain, and the like. The polypeptide may be formulated forimproved stability. For example, the peptides may be PEGylated, wherethe polyethyleneoxy group provides for enhanced lifetime in the bloodstream.

Additionally or alternatively, the cyclic-di-nucleotide active agent(s)may be fused to a polypeptide permeant domain to promote uptake by thecell. A number of permeant domains are known in the art and may be usedin the non-integrating polypeptides of the present invention, includingpeptides, peptidomimetics, and non-peptide carriers. For example, apermeant peptide may be derived from the third alpha helix of Drosophilamelanogaster transcription factor Antennapaedia, referred to aspenetratin, which comprises the amino acid sequence RQIKIWFQNRRMKWKK(SEQ ID NO:03). As another example, the permeant peptide comprises theHIV-1 tat basic region amino acid sequence, which may include, forexample, amino acids 49-57 of naturally-occurring tat protein. Otherpermeant domains include poly-arginine motifs, for example, the regionof amino acids 34-56 of HIV-1 rev protein, nona-arginine, octa-arginine,and the like. (See, for example, Futaki et al. Curr Protein Pept Sci.4(2): 87-96 (2003); and Wender et al. Proc. Natl. Acad. Sci. U.S.A97(24):13003-8 (2000); published U.S. Patent applications 20030220334;20030083256; 20030032593; and 20030022831, herein specificallyincorporated by reference for the teachings of translocation peptidesand peptoids). The nona-arginine (R9) sequence is one of the moreefficient PTDs that have been characterized (Wender et al. 2000; Uemuraet al. 2002). The site at which the fusion is made may be selected inorder to optimize the biological activity, secretion or bindingcharacteristics of the polypeptide. The optimal site will be determinedby routine experimentation.

In practicing embodiments of the methods provided herein, an effectiveamount of the active agent, i.e., a cyclic-di-nucleotide active agent(such as described above), is provided in the target cell or cells. Asused herein “effective amount” or “efficacious amount” means the amountof the active agent that, when contacted with the cell, e.g., by beingintroduced into the cell in vitro, by being administered to a subject,etc., is sufficient to result in increased levels of acyclic-di-nucleotide in the cell. The “effective amount” will varydepending on cell and/or the organism and/or compound and or the natureof the desired outcome and/or the disease and its severity and the age,weight, etc., of the subject to be treated.

In some instances, the effective amount of the active agent is providedin the cell by contacting the cell with the active agent. Contact of thecell with the active agent may occur using any convenient protocol. Theprotocol may provide for in vitro or in vivo contact of the active agentwith the target cell, depending on the location of the target cell. Forexample, where the target cell is an isolated cell, e.g., a cell invitro (i.e., in culture), or a cell ex vivo (“ex vivo” being cells ororgans are modified outside of the body, where such cells or organs aretypically returned to a living body), the active agent may be introduceddirectly into the cell under cell culture conditions permissive ofviability of the target cell. Such techniques include, but are notnecessarily limited to: viral infection, transfection, conjugation,protoplast fusion, electroporation, particle gun technology, calciumphosphate precipitation, direct microinjection, viral vector delivery,and the like. The choice of method is generally dependent on the type ofcell being contacted and the nature of the active agent, and thecircumstances under which the transformation is taking place (e.g., invitro, ex vivo, or in vivo). A general discussion of these methods canbe found in Ausubel, et al, Short Protocols in Molecular Biology, 3rded., Wiley & Sons, 1995. As another example, where the target cell orcells are part of a multicellular organism, the active agent may beadministered to the organism or subject in a manner such that the agentis able to contact the target cell(s), e.g., via an in vivo protocol. By“in vivo,” it is meant in the target construct is administered to aliving body of an animal.

In some embodiments, the cyclic-di-nucleotide active agent is employedto modulate c-di-AMP activity in mitotic or post-mitotic cells in vitroor ex vivo, i.e., to produce modified cells that can be reintroducedinto an individual. Mitotic and post-mitotic cells of interest in theseembodiments include any eukaryotic cell, e.g., pluripotent stem cells,for example, ES cells, iPS cells, and embryonic germ cells; somaticcells, for example, hematopoietic cells, fibroblasts, neurons, musclecells, bone cells, vascular endothelial cells, gut cells, and the like,and their lineage-restricted progenitors and precursors; and neoplastic,or cancer, cells, i.e., cells demonstrating one or more propertiesassociated with cancer cells, e.g., hyperproliferation, contactinhibition, the ability to invade other tissue, etc. In certainembodiments, the eukaryotic cells are cancer cells. In certainembodiments, the eukaryotic cells are hematopoietic cells, e.g.,macrophages, NK cells, etc. Cells may be from any mammalian species,e.g., murine, rodent, canine, feline, equine, bovine, ovine, primate,human, etc. Cells may be from established cell lines or they may beprimary cells, where “primary cells”, “primary cell lines”, and “primarycultures” are used interchangeably herein to refer to cells and cellscultures that have been derived from a subject and allowed to grow invitro for a limited number of passages, i.e., splittings, of theculture. For example, primary cultures are cultures that may have beenpassaged 0 times, 1 time, 2 times, 4 times, 5 times, 10 times, or 15times, but not enough times go through the crisis stage. Typically, theprimary cell lines of the present invention are maintained for fewerthan 10 passages in vitro.

If the cells are primary cells, they may be harvested from an individualby any convenient method. For example, blood cells, e.g., leukocytes,e.g., macrophages, may be harvested by apheresis, leukocytapheresis,density gradient separation, etc., while cells from tissues such asskin, muscle, bone marrow, spleen, liver, pancreas, lung, intestine,stomach, etc. may be harvested by biopsy. An appropriate solution may beused for dispersion or suspension of the harvested cells. Such solutionwill generally be a balanced salt solution, e.g., normal saline, PBS,Hank's balanced salt solution, etc., conveniently supplemented withfetal calf serum or other naturally occurring factors, in conjunctionwith an acceptable buffer at low concentration, generally from 5-25 mM.Convenient buffers include HEPES, phosphate buffers, lactate buffers,etc. The cells may be used immediately, or they may be stored, frozen,for long periods of time, being thawed and capable of being reused. Insuch cases, the cells may be frozen in 10% DMSO, 50% serum, 40% bufferedmedium, or some other such solution as is commonly used in the art topreserve cells at such freezing temperatures, and thawed in a manner ascommonly known in the art for thawing frozen cultured cells.

The cyclic-di-nucleotide active agent(s) may be produced by eukaryoticcells or by prokaryotic cells, it may be further processed by unfolding,e.g., heat denaturation, DTT reduction, etc. and may be furtherrefolded, using methods known in the art.

Modifications of interest that do not alter primary sequence includechemical derivatization of polypeptides, e.g., acylation, acetylation,carboxylation, amidation, etc. Also included are modifications ofglycosylation, e.g., those made by modifying the glycosylation patternsof a polypeptide during its synthesis and processing or in furtherprocessing steps; e.g., by exposing the polypeptide to enzymes whichaffect glycosylation, such as mammalian glycosylating or deglycosylatingenzymes. Also embraced are sequences that have phosphorylated amino acidresidues, e.g., phosphotyrosine, phosphoserine, or phosphothreonine.

Also included in the subject invention are cyclic-di-nucleotide activeagent polypeptides (e.g., cGAS polypeptides) that have been modifiedusing ordinary molecular biological techniques and synthetic chemistryso as to improve their resistance to proteolytic degradation or tooptimize solubility properties or to render them more suitable as atherapeutic agent. Analogs of such polypeptides include those containingresidues other than naturally occurring L-amino acids, e.g., D-aminoacids or non-naturally occurring synthetic amino acids. D-amino acidsmay be substituted for some or all of the amino acid residues.

The cyclic-di-nucleotide active agent (s) may be prepared by in vitrosynthesis, using any suitable method. Various commercial syntheticapparatuses are available, for example, automated synthesizers byApplied Biosystems, Inc., Beckman, etc. By using synthesizers, naturallyoccurring amino acids may be substituted with unnatural amino acids. Theparticular sequence and the manner of preparation will be determined byconvenience, economics, purity required, and the like.

If desired, various groups may be introduced into the peptide duringsynthesis or during expression, which allow for linking to othermolecules or to a surface. Thus cysteines can be used to makethioethers, histidines for linking to a metal ion complex, carboxylgroups for forming amides or esters, amino groups for forming amides,and the like.

The cyclic-di-nucleotide active agent(s) may also be isolated andpurified in accordance with conventional methods of recombinantsynthesis. A lysate may be prepared of the expression host and thelysate purified using HPLC, exclusion chromatography, gelelectrophoresis, affinity chromatography, or other purificationtechnique. For the most part, the compositions which are used willinclude 20% or more by weight of the desired product, such as 75% ormore by weight of the desired product, including 95% or more by weightof the desired product, and for therapeutic purposes, may be 99.5% ormore by weight, in relation to contaminants related to the method ofpreparation of the product and its purification (where the percentagesmay be based upon total protein).

To modulate cyclic-di-nucleotide activity and/or production, thecyclic-di-nucleotide active agent(s)—be they small molecules (e.g.,2′-5′ phosphodiester linkage containing cyclic-di-nucleotides)polypeptides or nucleic acids that encode cyclic-di-nucleotide activeagent polypeptides (e.g., cGAS)—may be provided to the cells for asufficient period of time, e.g., from 30 minutes to 24 hours, e.g., 1hour, 1.5 hours, 2 hours, 2.5 hours, 3 hours, 3.5 hours 4 hours, 5hours, 6 hours, 7 hours, 8 hours, 12 hours, 16 hours, 18 hours, 20hours, or any other period from 30 minutes to 24 hours, which may berepeated with a frequency of every day to every 4 days, e.g., every 1.5days, every 2 days, every 3 days, or any other frequency from aboutevery day to about every four days. The agent(s) may be provided to thesubject cells one or more times, e.g., one time, twice, three times, ormore than three times, and the cells allowed to incubate with theagent(s) for some amount of time following each contacting event e.g.,16-24 hours, after which time the media is replaced with fresh media andthe cells are cultured further.

In certain embodiments, two or more, three or more, four or more, fiveor more, six or more, seven or more, eight or more, nine or more, or tenor more different cyclic-di-nucleotide active agents are provided to acell in a manner sufficient to increase production of a type Iinterferon by the cell. In some instances, the active agents include twoor more different 2′-5′ phosphodiester linkage comprisingcyclic-di-nucleotides. In certain embodiments, the active agents includea 2′-5′ phosphodiester linkage containing cyclic-di-nucleotide and anucleic acid encoding cGAS or a cGAS polypeptide. In instances in whichtwo or more different cyclic-di-nucleotide active agents are provided tothe cell, i.e., a cyclic-di-nucleotide active agent cocktail, thecyclic-di-nucleotide active agent(s) may be provided simultaneously,e.g., as two cyclic-di-nucleotides delivered simultaneously or acyclic-di-nucleotide and a vector containing a nucleic acid encodingcGAS delivered simultaneously. Alternatively, they may be providedconsecutively, e.g., the first cyclic-di-nucleotide active agent beingprovided first, followed by the cyclic-di-nucleotide active agent, etc.or vice versa.

An effective amount of cyclic-di-nucleotide active agent(s) are providedto the cells to result in a change in cyclic-di-nucleotide levels. Aneffective amount of cyclic-di-nucleotide active agent is the amount toresult in a 2-fold increase or more in the amount ofcyclic-di-nucleotide production observed relative to a negative control,e.g., a cell contacted with an empty vector or irrelevant polypeptide.That is to say, an effective amount or dose of a cyclic-di-nucleotideactive agent will result in a 2-fold increase, a 3-fold increase, a4-fold increase or more in the amount of cyclic-di-nucleotide observed,in some instances a 5-fold increase, a 6-fold increase or more,sometimes a 7-fold or 8-fold increase or more in the amount of activityobserved, e.g., an increase of 10-fold, 50-fold, or 100-fold or more, insome instances, an increase of 200-fold, 500-fold, 700-fold, or1000-fold or more, in the amount of activity observed. The amount ofactivity may be measured by any suitable method. For example, the amountof interferon produced by the cell may be assessed after contact withthe cyclic-di-nucleotide active agent(s), e.g., 2 hours, 4 hours, 8hours, 12 hours, 24 hours, 36 hours, 48 hours, 72 hours or more aftercontact with the cyclic-di-nucleotide active agent(s).

Contacting the cells with the cyclic-di-nucleotide active agent(s) mayoccur in any culture media and under any culture conditions that promotethe survival of the cells. For example, cells may be suspended in anyappropriate nutrient medium that is convenient, such as Iscove'smodified DMEM or RPMI 1640, supplemented with fetal calf serum or heatinactivated goat serum (about 5-10%), L-glutamine, a thiol, particularly2-mercaptoethanol, and antibiotics, e.g., penicillin and streptomycin.The culture may contain growth factors to which the cells areresponsive. Growth factors, as defined herein, are molecules capable ofpromoting survival, growth and/or differentiation of cells, either inculture or in the intact tissue, through specific effects on atransmembrane receptor. Growth factors include polypeptides andnon-polypeptide factors.

Following the methods described above, a cell may be modified ex vivo tohave an increase in cyclic-di-nucleotide levels. In some embodiments, itmay be desirous to select for the modified cell, e.g., to create anenriched population of modified cells. Any convenient modification tothe cells that marks the cells as modified with a cyclic-di-nucleotideactive agent may be used. For example, a selectable marker may beinserted into the genome of the cell, so that the population of cellsmay be enriched for those comprising the genetic modification byseparating the genetically marked cells from the remaining population.Separation may be by any convenient separation technique appropriate forthe selectable marker used. For example, if a fluorescent marker hasbeen inserted, cells may be separated by fluorescence activated cellsorting, whereas if a cell surface marker has been inserted, cells maybe separated from the heterogeneous population by affinity separationtechniques, e.g., magnetic separation, affinity chromatography,“panning” with an affinity reagent attached to a solid matrix, or otherconvenient technique. Techniques providing accurate separation includefluorescence activated cell sorters, which can have varying degrees ofsophistication, such as multiple color channels, low angle and obtuselight scattering detecting channels, impedance channels, etc. The cellsmay be selected against dead cells by employing dyes associated withdead cells (e.g., propidium iodide). Any technique may be employed whichis not unduly detrimental to the viability of the genetically modifiedcells.

Cell compositions that are highly enriched for cells comprisingcyclic-di-nucleotide active agent(s) are achieved in this manner. By“highly enriched”, it is meant that the genetically modified cells willbe 70% or more, 75% or more, 80% or more, 85% or more, 90% or more ofthe cell composition, for example, about 95% or more, or 98% or more ofthe cell composition. In other words, the composition may be asubstantially pure composition of cells comprising cyclic-di-nucleotideactive agent(s).

Cells comprising cyclic-di-nucleotide active agent(s) produced by themethods described herein may be used immediately. Alternatively, thecells may be frozen at liquid nitrogen temperatures and stored for longperiods of time, being thawed and capable of being reused. In suchcases, the cells may be frozen in 10% DMSO, 50% serum, 40% bufferedmedium, or some other such solution as is commonly used in the art topreserve cells at such freezing temperatures, and thawed in a manner ascommonly known in the art for thawing frozen cultured cells.

The cells comprising cyclic-di-nucleotide active agent(s) may becultured in vitro under various culture conditions. The cells may beexpanded in culture, i.e., grown under conditions that promote theirproliferation. Culture medium may be liquid or semi-solid, e.g.,containing agar, methylcellulose, etc. The cell population may besuspended in an appropriate nutrient medium, such as Iscove's modifiedDMEM or RPMI 1640, normally supplemented with fetal calf serum (about5-10%), L-glutamine, a thiol, particularly 2-mercaptoethanol, andantibiotics, e.g., penicillin and streptomycin. The culture may containgrowth factors to which the regulatory T cells are responsive. Growthfactors, as defined herein, are molecules capable of promoting survival,growth and/or differentiation of cells, either in culture or in theintact tissue, through specific effects on a transmembrane receptor.Growth factors include polypeptides and non-polypeptide factors.

Cells that have been modified with cyclic-di-nucleotide active agent(s)may be transplanted to a subject to treat a disease or as an antiviral,antipathogenic, or anticancer therapeutic or for biological research.The subject may be a neonate, a juvenile, or an adult. Of particularinterest are mammalian subjects. Mammalian species that may be treatedwith the present methods include canines and felines; equines; bovines;ovines; etc. and primates, particularly humans. Animal models,particularly small mammals, e.g., murine, lagomorpha, etc., may be usedfor experimental investigations.

Cells may be provided to the subject alone or with a suitable substrateor matrix, e.g., to support their growth and/or organization in thetissue to which they are being transplanted. In some instances, at least1×10³ cells will be administered, for example 5×10³ cells, 1×10⁴ cells,5×10⁴ cells, 1×10⁵ cells, 1×10⁶ cells or more. The cells may beintroduced to the subject via any of the following routes: parenteral,subcutaneous, intravenous, intracranial, intraspinal, intraocular, orinto spinal fluid. The cells may be introduced by injection, catheter,or the like. Examples of methods for local delivery, that is, deliveryto the site of injury, include, e.g., through an Ommaya reservoir, e.g.,for intrathecal delivery (see, e.g., U.S. Pat. Nos. 5,222,982 and5,385,582, incorporated herein by reference); by bolus injection, e.g.,by a syringe, e.g., into a joint; by continuous infusion, e.g., bycannulation, e.g., with convection (see e.g., US Application No.20070254842, incorporated here by reference); or by implanting a deviceupon which the cells have been reversibly affixed (see e.g., USApplication Nos. 20080081064 and 20090196903, incorporated herein byreference).

In other aspects of the invention, the cyclic-di-nucleotide activeagent(s) are employed to increase the production of type I interferon invivo. In these in vivo embodiments, the cyclic-di-nucleotide activeagent(s) are administered directly to the individual. In someembodiments, the cyclic-di-nucleotide active agent administered to thesubject contains a 2′-5′ phosphodiester linkage containingcyclic-di-nucleotide.

Cyclic-di-nucleotide active agent(s) may be administered by any suitablemethods for the administration of peptides, small molecules and nucleicacids to a subject. The cyclic-di-nucleotide active agent(s) can beincorporated into a variety of formulations. More particularly, thecyclic-di-nucleotide active agent(s) of the present invention can beformulated into pharmaceutical compositions by combination withappropriate pharmaceutically acceptable carriers or diluents.Pharmaceutical compositions that can be used in practicing the subjectmethods are described below.

In such instances, an effective amount of the cyclic-di-nucleotideactive agent is administered to the subject. By an “effective amount” ora “therapeutically effective amount” of the cyclic-di-nucleotide activeagent it is meant an amount that is required to reduce the severity, theduration and/or the symptoms of the disease. In some embodiments, theeffective amount of a pharmaceutical composition containing acyclic-di-nucleotide active agent, as provided herein, is between 0.025mg/kg and 1000 mg/kg body weight of a human subject. In certainembodiments, the pharmaceutical composition is administered to a humansubject at an amount of 1000 mg/kg body weight or less, 950 mg/kg bodyweight or less, 900 mg/kg body weight or less, 850 mg/kg body weight orless, 800 mg/kg body weight or less, 750 mg/kg body weight or less, 700mg/kg body weight or less, 650 mg/kg body weight or less, 600 mg/kg bodyweight or less, 550 mg/kg body weight or less, 500 mg/kg body weight orless, 450 mg/kg body weight or less, 400 mg/kg body weight or less, 350mg/kg body weight or less, 300 mg/kg body weight or less, 250 mg/kg bodyweight or less, 200 mg/kg body weight or less, 150 mg/kg body weight orless, 100 mg/kg body weight or less, 95 mg/kg body weight or less, 90mg/kg body weight or less, 85 mg/kg body weight or less, 80 mg/kg bodyweight or less, 75 mg/kg body weight or less, 70 mg/kg body weight orless, or 65 mg/kg body weight or less.

In another aspect, provided herein is a method for increasing astimulator of interferon genes (STING) mediated response in a subject,e.g., a STING mediated immune response. In certain embodiments, themethod includes the step of administering to the subject an amount of aSTING active agent effective to increase a STING mediated response inthe subject. A “STING” mediated response refers to any response that ismediated by STING, including, but not limited to, immune responses tobacterial pathogens, viral pathogens, and eukaryotic pathogens. See,e.g., Ishikawa et al. Immunity 29: 538-550 (2008); Ishikawa et al.Nature 461: 788-792 (2009); and Sharma et al. Immunity 35: 194-207(2011). STING also functions in certain autoimmune diseases initiated byinappropriate recognition of self DNA (see, e.g., Gall et al. Immunity36: 120-131 (2012), as well as for the induction of adaptive immunity inresponse to DNA vaccines (see, e.g., Ishikawa et al. Nature 461: 788-792(2009). By increasing a STING mediated response in a subject is meant anincrease in a STING mediated response in a subject as compared to acontrol subject (e.g., a subject who is not administered a STING activeagent). In certain embodiments, the method is for increasing astimulator of interferon genes (STING) mediated response in a subject,wherein the STING mediated response is non-responsive to acyclic-di-nucleotide having two 3′-5′ phosphodiester bonds (i.e., acanonical cyclic dinucleotide).

As described in the Experimental Section below, cyclic-di-nucleotideshaving 2′-5′ phosphodiester bonds have been shown to activate STINGsignaling. Moreover, such cyclic-di-nucleotides having 2′-5′phosphodiester bonds have been shown to stimulate alleles of STING thatare non-responsive to cyclic-di-nucleotides that have two phosphodiesterbonds. As such, in some embodiments, the STING active agent is acyclic-di-nucleotide active agent described herein (e.g.,cyclic-di-nucleotide, nucleic acid encoding cGAS).

In other embodiments the STING active agent is a nucleic acid encodingSTING or a STING polypeptide. Nucleic acids encoding various STINGsinclude, but are not limited to, those described in: Nitta et al.Hepatology 57(1): 46-58 (2013) and Jin et al. J. Immunol. 190(6):2835-2843 (2013) and those deposited in GENBANK and assigned depositnumbers: NM_(—)198282.2 and NP_(—)938023.1 (human); NM_(—)028261.1 andNP_(—)082537.1 (mus musculus); and NM_(—)057386.4 and NP_(—)476734.1(Drosophila melanogaster).

In certain embodiments, the nucleic acid encoding STING has thefollowing sequence:

(SEQ ID NO: 04) gttcatttttcactcctccctcctaggtcacacttttcagaaaaagaatctgcatcctggaaaccagaagaaaaatatgagacggggaatcatcgtgtgatgtgtgtgctgcctttggctgagtgtgtggagtcctgctcaggtgttaggtacagtgtgtttgatcgtggtggcttgaggggaacccgctgttcagagctgtgactgcggctgcactcagagaagctgcccttggctgctcgtagcgccgggccttctctcctcgtcatcatccagagcagccagtgtccgggaggcagaagatgccccactccagcctgcatccatccatcccgtgtcccaggggtcacggggcccagaaggcagccttggttctgctgagtgcctgcctggtgaccctttgggggctaggagagccaccagagcacactctccggtacctggtgctccacctagcctccctgcagctgggactgctgttaaacggggtctgcagcctggctgaggagctgcgccacatccactccaggtaccggggcagctactggaggactgtgcgggcctgcctgggctgccccctccgccgtggggccctgttgctgctgtccatctatttctactactccctcccaaatgcggtcggcccgcccttcacttggatgcttgccctcctgggcctctcgcaggcactgaacatcctcctgggcctcaagggcctggccccagctgagatctctgcagtgtgtgaaaaagggaatttcaacgtggcccatgggctggcatggtcatattacatcggatatctgcggctgatcctgccagagctccaggcccggattcgaacttacaatcagcattacaacaacctgctacggggtgcagtgagccagcggctgtatattctcctcccattggactgtggggtgcctgataacctgagtatggctgaccccaacattcgcttcctggataaactgccccagcagaccggtgaccatgctggcatcaaggatcgggtttacagcaacagcatctatgagcttctggagaacgggcagcgggcgggcacctgtgtcctggagtacgccacccccttgcagactttgtttgccatgtcacaatacagtcaagctggctttagccgggaggataggcttgagcaggccaaactcttctgccggacacttgaggacatcctggcagatgcccctgagtctcagaacaactgccgcctcattgcctaccaggaacctgcagatgacagcagcttctcgctgtcccaggaggttctccggcacctgcggcaggaggaaaaggaagaggttactgtgggcagcttgaagacctcagcggtgcccagtacctccacgatgtcccaagagcctgagctcctcatcagtggaatggaaaagcccctccctctccgcacggatttctcttgagacccagggtcaccaggccagagcctccagtggtctccaagcctctggactgggggctctcttcagtggctgaatgtccagcagagctatttccttccacagggggccttgcagggaagggtccaggacttgacatcttaagatgcgtcttgtccccttgggccagtcatttcccctctctgagcctcggtgtcttcaacctgtgaaatgggatcataatcactgccttacctccctcacggttgttgtgaggactgagtgtgtggaagtttttcataaactttggatgctagtgtacttagggggtgtgccaggtgtctttcatggggccttccagacccactccccacccttctccccttcctttgcccggggacgccgaactctctcaatggtatcaacaggctccttcgccctctggctcctggtcatgttccattattggggagccccagcagaagaatggagaggaggaggaggctgagtttggggtattgaatcccccggctcccaccctgcagcatcaaggttgctatggactctcctgccgggcaactcttgcgtaatcatgactatctctaggattctggcaccacttccttccctggccccttaagcctagctgtgtatcggcacccccaccccactagagtactccctctcacttgcggtttccttatactccacccctttctcaacggtccttttttaaagcacatctcagattacccaaaaaaaaaaaaaaaaaa. 

In some embodiments, the nucleic acid encoding STING is a nucleic acidwith 40% to 99%, 45% to 99%, 50% to 99%, 55% to 99%, 60% to 99%, 65% to99%, 70% to 99%, 75% to 99%, 80% to 99%, 85% to 99%, 90% to 99% or, 95%to 99% sequence identity with a wild type STING nucleic acid sequence.In some embodiments, the nucleic acid encoding STING is a nucleic acidwith 40% to 50%, 50% to 60%, 60% to 70%, 70% to 80%, 80% to 90%, or 90to 99% sequence identity with a wild type STING nucleic acid sequence.In some embodiments, the nucleic acid encoding STING is a nucleic acidwith 40% or more, 45% or more, 50% or more, 55% or more, 60% or more,70% or more, 75% or more, 80% or more, 85% or more, 90% or more, 95% ormore or 99% or more sequence identity with a wild type STING nucleicacid sequence.

Amino acid sequences of STING include, but are not limited to, thosedescribed in: Nitta et al. Hepatology 57(1): 46-58 (2013) and Jin et al.J. Immunol. 190(6): 2835-2843 (2013) and those deposited in GENBANK andassigned deposit numbers: NM_(—)198282.2 and NP_(—)938023.1 (human);NM_(—)028261.1 and NP_(—)082537.1 (mus musculus); and NM_(—)057386.4 andNP_(—)476734.1 (Drosophila melanogaster).

In certain embodiments, the STING polypeptide has the followingsequence:

(SEQ ID NO: 05) MPHSSLHPSIPCPRGHGAQKAALVLLSACLVTLWGLGEPPEHTLRYLVLHLASLQLGLLLNGVCSLAEELRHIHSRYRGSYWRTVRACLGCPLRRGALLLLSIYFYYSLPNAVGPPFTWMLALLGLSQALNILLGLKGLAPAEISAVCEKGNFNVAHGLAWSYYIGYLRLILPELQARIRTYNQHYNNLLRGAVSQRLYILLPLDCGVPDNLSMADPNIRFLDKLPQQTGDHAGIKDRVYSNSIYELLENGQRAGTCVLEYATPLQTLFAMSQYSQAGFSREDRLEQAKLFCRTLEDILADAPESQNNCRLIAYQEPADDSSFSLSQEVLRHLRQEEKEEVTVGSLKTSAVPSTSTMSQEPELLISGMEKPLPLRTDFS.

In other embodiments, the STING polypeptide has the following sequence:

(SEQ ID NO: 06) MPHSSLHPSIPCPRGHGAQKAALVLLSACLVTLWGLGEPPEHTLRYLVLHLASLQLGLLLNGVCSLAEELHHIHSRYRGSYWRTVRACLGCPLRRGALLLLSIYFYYSLPNAVGPPFTWMLALLGLSQALNILLGLKGLAPAEISAVCEKGNFNVAHGLAWSYYIGYLRLILPELQARIRTYNQHYNNLLRGAVSQRLYILLPLDCGVPDNLSMADPNIRFLDKLPQQTADRAGIKDRVYSNSIYELLENGQRAGTCVLEYATPLQTLFAMSQYSQAGFSREDRLEQAKLFCQTLEDILADAPESQNNCRLIAYQEPADDSSFSLSQEVLRHLRQEEKEEVTVGSLKTSAVPSTSTMSQEPELLISGMEKPLPLRTDFS.

In some embodiments, the STING polypeptide is a polypeptide that has 40%to 99%, 45% to 99%, 50% to 99%, 55% to 99%, 60% to 99%, 65% to 99%, 70%to 99%, 75% to 99%, 80% to 99%, 85% to 99%, 90% to 99% or, 95% to 99%sequence identity with a wild type STING amino acid sequence. In someembodiments, the cGAS polypeptide is a polypeptide that has 40% to 50%,50% to 60%, 60% to 70%, 70% to 80%, 80% to 90%, or 90 to 99% sequenceidentity with a wild type STING amino acid sequence. In someembodiments, the STING polypeptide is a polypeptide that has 40% ormore, 45% or more, 50% or more, 55% or more, 60% or more, 70% or more,75% or more, 80% or more, 85% or more, 90% or more, 95% or more or 99%or more sequence identity with a wild type STING amino acid sequence.

The above methods find use in a variety of different applications.Certain applications are now reviewed in the following Utility section.

Utility

The methods and compositions provided herein find use in a variety ofapplications, where such applications include increasing type Iinterferon (e.g., interferon-β) in a subject is desired. In addition,the methods and compositions provided herein find use in a variety ofapplications, where such applications include increasing STING mediatedresponse in a subject is desired. Specific applications of interestinclude those in which a subject is treated for a disease condition thatwould benefit from an increase in type I interferon by providing thesubject with a therapeutically effective amount of acyclic-di-nucleotide active agent. In some instances, it may bedesirable to increase a type I interferon or STING mediated response ina healthy individual, e.g., for the prevention of a disease orcondition. As such, in some embodiments, the methods and compositionsprovided herein can be used to produce an ‘adjuvant’ effect in a vaccineto prevent an infection or other disease, wherein the active agentstimulates immunological memory to protect against future disease orinfection.

In some embodiments, subjects suitable for treatment with a methoddescribed herein include individuals having an immunological orinflammatory disease or disorder including, but not limited to a cancer,an autoimmune disease or disorder, an allergic reaction, a chronicinfectious disease and an immunodeficiency disease or disorder.

In some embodiments, subjects suitable for treatment with a method ofthe present invention include individuals having a cellularproliferative disease, such as a neoplastic disease (e.g., cancer).Cellular proliferative disease is characterized by the undesiredpropagation of cells, including, but not limited to, neoplastic diseaseconditions, e.g., cancer.

Examples of cellular proliferative disease include, but not limited to,abnormal stimulation of endothelial cells (e.g., atherosclerosis), solidtumors and tumor metastasis, benign tumors, for example, hemangiomas,acoustic neuromas, neurofibromas, trachomas, and pyogenic granulomas,vascular malfunctions, abnormal wound healing, inflammatory and immunedisorders, Bechet's disease, gout or gouty arthritis, abnormalangiogenesis accompanying, for example, rheumatoid arthritis, psoriasis,diabetic retinopathy, other ocular angiogenic diseases such asretinopathy of prematurity (retrolental fibroplastic), maculardegeneration, corneal graft rejection, neurovascular glaucoma and OsterWebber syndrome, psoriasis, restenosis, fungal, parasitic and viralinfections such cytomegaloviral infections. Subjects to be treatedaccording to the methods of the invention include any individual havingany of the above-mentioned disorders.

In other embodiments, subjects suitable for treatment with a subjectmethod include individuals who have been clinically diagnosed asinfected with a virus. In some embodiments, the virus is a hepatitisvirus (e.g., HAV, HBV, HCV, delta, etc.), particularly HCV, are suitablefor treatment with the methods of the instant invention. Individuals whoare infected with HCV are identified as having HCV RNA in their blood,and/or having anti-HCV antibody in their serum. Such individuals includenaïve individuals (e.g., individuals not previously treated for HCV,particularly those who have not previously received IFN-α-based orribavirin-based therapy) and individuals who have failed prior treatmentfor HCV.

In some embodiments, subjects suitable for treatment with a methodprovided herein include an individual with a neurodegenerative diseaseor disorder, including, but not limited to, Parkinson's disease,Alzheimer's disease, Huntington's disease, and Amyotrophic lateralsclerosis (ALS).

In other embodiments, subjects suitable for treatment with a method ofthe present invention include individuals having multiple sclerosis.Multiple sclerosis refers to an autoimmune neurodegenerative disease,which is marked by inflammation within the central nervous system withlymphocyte attack against myelin produced by oligodendrocytes, plaqueformation and demyelization with destruction of the myelin sheath ofaxons in the brain and spinal cord, leading to significant neurologicaldisability over time. Typically, at onset an otherwise healthy personpresents with the acute or sub acute onset of neurologicalsymptomatology (attack) manifested by unilateral loss of vision,vertigo, ataxia, dyscoordination, gait difficulties, sensory impairmentcharacterized by paresthesia, dysesthesia, sensory loss, urinarydisturbances until incontinence, diplopia, dysarthria or various degreesof motor weakness until paralysis. The symptoms may be painless, remainfor several days to a few weeks, and then partially or completelyresolve. After a period of remission, a second attack will occur. Duringthis period after the first attack, the patient is defined to sufferfrom probable MS. Probable MS patients may remain undiagnosed for years.When the second attack occurs the diagnosis of clinically definite MS(CDMS) is made (Poser criteria 1983; C. M. Poser et al., Ann. Neurol.1983; 13, 227).

The terms “subject” and “patient” mean a member or members of anymammalian or non-mammalian species that may have a need for thepharmaceutical methods, compositions and treatments described herein.Subjects and patients thus include, without limitation, primate(including humans), canine, feline, ungulate (e.g., equine, bovine,swine (e.g., pig)), avian, and other subjects. Humans and non-humananimals having commercial importance (e.g., livestock and domesticatedanimals) are of particular interest.

“Mammal” means a member or members of any mammalian species, andincludes, by way of example, canines; felines; equines; bovines; ovines;rodentia, etc. and primates, particularly humans. Non-human animalmodels, particularly mammals, e.g., primate, murine, lagomorpha, etc.may be used for experimental investigations.

“Treating” or “treatment” of a condition or disease includes: (1)preventing at least one symptom of the conditions, i.e., causing aclinical symptom to not significantly develop in a mammal that may beexposed to or predisposed to the disease but does not yet experience ordisplay symptoms of the disease, (2) inhibiting the disease, i.e.,arresting or reducing the development of the disease or its symptoms, or(3) relieving the disease, i.e., causing regression of the disease orits clinical symptoms. As used herein, the term “treating” is thus usedto refer to both prevention of disease, and treatment of pre-existingconditions. For example, where the cyclic-di-nucleotide active agent isadministered, the prevention of cellular proliferation can beaccomplished by administration of the subject compounds prior todevelopment of overt disease, e.g., to prevent the regrowth of tumors,prevent metastatic growth, etc. Alternatively the compounds are used totreat ongoing disease, by stabilizing or improving the clinical symptomsof the patient.

Combination Therapy

For use in the subject methods, the cyclic-di-nucleotide active agentdescribed herein may be administered in combination with otherpharmaceutically active agents, including other agents that treat theunderlying condition or a symptom of the condition. “In combinationwith” as used herein refers to uses where, for example, the firstcompound is administered during the entire course of administration ofthe second compound; where the first compound is administered for aperiod of time that is overlapping with the administration of the secondcompound, e.g., where administration of the first compound begins beforethe administration of the second compound and the administration of thefirst compound ends before the administration of the second compoundends; where the administration of the second compound begins before theadministration of the first compound and the administration of thesecond compound ends before the administration of the first compoundends; where the administration of the first compound begins beforeadministration of the second compound begins and the administration ofthe second compound ends before the administration of the first compoundends; where the administration of the second compound begins beforeadministration of the first compound begins and the administration ofthe first compound ends before the administration of the second compoundends. As such, “in combination” can also refer to regimen involvingadministration of two or more compounds. “In combination with” as usedherein also refers to administration of two or more compounds that maybe administered in the same or different formulations, by the same ofdifferent routes, and in the same or different dosage form type.

Examples of other agents for use in combination therapy of neoplasticdisease include, but are not limited to, thalidomide, marimastat, COL-3,BMS-275291, squalamine, 2-ME, SU6668, neovastat, Medi-522, EMD121974,CAI, celecoxib, interleukin-12, IM862, TNP470, avastin, gleevec,herceptin, and mixtures thereof. Examples of chemotherapeutic agents foruse in combination therapy include, but are not limited to,daunorubicin, daunomycin, dactinomycin, doxorubicin, epirubicin,idarubicin, esorubicin, bleomycin, mafosfamide, ifosfamide, cytosinearabinoside, bis-chloroethylnitrosurea, busulfan, mitomycin C,actinomycin D, mithramycin, prednisone, hydroxyprogesterone,testosterone, tamoxifen, dacarbazine, procarbazine, hexamethylmelamine,pentamethylmelamine, mitoxantrone, amsacrine, chlorambucil,methylcyclohexylnitrosurea, nitrogen mustards, melphalan,cyclophosphamide, 6-mercaptopurine, 6-thioguanine, cytarabine,5-azacytidine, hydroxyurea, deoxycoformycin,4-hydroxyperoxycyclophosphor-amide, 5-fluorouracil (5-FU),5-fluorodeoxyuridine (5-FUdR), methotrexate (MTX), colchicine, taxol,vincristine, vinblastine, etoposide (VP-16), trimetrexate, irinotecan,topotecan, gemcitabine, teniposide, cisplatin and diethylstilbestrol(DES).

Other antiviral agents can also be delivered in the treatment methods ofthe invention. For example, compounds that inhibit inosine monophosphatedehydrogenase (IMPDH) may have the potential to exert direct anti viralactivity, and such compounds can be administered in combination with themutant Listeria, as described herein. Drugs that are effectiveinhibitors of hepatitis C NS3 protease may be administered incombination with the mutant Listeria, as described herein. Hepatitis CNS3 protease inhibitors inhibit viral replication. Other agents such asinhibitors of HCV NS3 helicase are also attractive drugs forcombinational therapy, and are contemplated for use in combinationtherapies described herein. Ribozymes such as Heptazyme™ andphosphorothioate oligonucleotides which are complementary to HCV proteinsequences and which inhibit the expression of viral core proteins arealso suitable for use in combination therapies described herein.Examples of other agents for use in combination therapy of multiplesclerosis include, but are not limited to; glatiramer; corticosteroids;muscle relaxants, such as Tizanidine (Zanaflex) and baclofen (Lioresal);medications to reduce fatigue, such as amantadine (Symmetrel) ormodafinil (Provigil); and other medications that may also be used fordepression, pain and bladder or bowel control problems that can beassociated with MS.

In the context of a combination therapy, combination therapy compoundsmay be administered by the same route of administration (e.g.,intrapulmonary, oral, enteral, etc.) that the cyclic-di-nucleotideactive agents are administered. In the alternative, the compounds foruse in combination therapy with the cyclic-di-nucleotide active agentmay be administered by a different route of administration.

Adjuvants

In certain embodiments, the cyclic di-nucleotide active agent functionsas an adjuvant when administered together with a drug or vaccine totreat or prevent a disease or condition, including, but not limited to,those diseases and conditions provided herein. In some embodiments, thecyclic di-nucleotide active agents are administered together with avaccine. Such active agents that are administered with a vaccine canfunction as an adjuvant to enhance the immune response elicited by thevaccine, including stimulating immunological memory to protect againstfuture diseases and/or infections.

In certain embodiments, the cyclic di-nucleotide or STING active agentsadministered as an adjuvant for a vaccine can enhance the effectivenessof the vaccine by, e.g., increasing the immunogenicity of weakerantigens, reducing the amount of antigen required to elicit a immuneresponse, reducing the frequency of immunization necessary to maintainprotective immunity, enhance the efficacy of vaccines inimmunocompromised or other individuals with reduced immune responses,and/or increase immunity at a target tissue, such as mucosal immunity.In such embodiments, the cyclic di-nucleotide active agents, whenco-administered with one or more antigens, can induce a particularcytokine profile to promote cellular and humoral immunity against theantigen and increase the effectiveness of vaccination.

Antigens used to prepare vaccines may be derived from a variety ofmicroorganisms such as viruses, bacteria and parasites that containsubstances that are not normally present in the body, as well as tumorcells. These substances can be used as antigens to produce an immuneresponse to destroy both the antigen and cells containing the antigen,such as a bacterial cell or cancer cell. In certain instances, isolatedor crude antigens of microbial pathogens can be used in vaccines totreat infectious disease; isolated or crude tumor cell antigens can beused in vaccines to treat cancer; isolated or crude antigens known to beassociated with a pathologically aberrant cell can be used to treat avariety of diseases in which it is beneficial to target particular cellsfor destruction.

Microorganisms that may be a source of antigen include clinicallyrelevant microorganisms, such as bacteria, including pathogenicbacteria; viruses (e.g., Influenza, Measles, Coronavirus); parasites(e.g., Trypanosome, Plasmodium, Leishmania); fungi (e.g., Aspergillus,Candida, Coccidioides, Cryptococcus); and the like. For example, theantigen may be from bacteria, particularly pathogenic bacteria, such asthe causative agent of anthrax (Bacillus anthracis), plague (Yersiniapestis), tuberculosis (Mycobacterium tuberculosis), salmonellosis(Salmonella enterica), stomach cancer (Helicobacter pylori), sexuallytransmitted diseases (Chlamydia trachomatis or Neisseria gonorrhea), andthe like. Other representative examples include antigens from certainviruses, such as influenza virus(es), Norwalk virus, smallpox virus,West Nile virus, SARS virus, MERS virus, respiratory syncytial virus,measles virus, and the like. Fungi of interest include, but are notlimited to Candida albicans or Aspergillus spp., and parasites ofinterest include the causative agents of trypanosomiasis, leishmania,pneumonic plague, and lyme disease (Borrellia burgdorferi).

A pathologically aberrant cell to be used in a vaccine can be obtainedfrom any source such as one or more individuals having a pathologicalcondition or ex vivo or in vitro cultured cells obtained from one ormore such individuals, including a specific individual to be treatedwith the resulting vaccine.

A vaccine formulation for use with an adjuvant containing cyclicdi-nucleotide active agents may include, e.g., attenuated andinactivated viral and bacterial pathogens from infected patients orpropagated cultures, purified macromolecules, polysaccharides, toxoids,recombinant antigens, organisms containing a foreign gene from apathogen, synthetic peptides, polynucleic acids, antibodies and tumorcells.

Recombinant antigens may be obtained, for example, by isolating andcloning a gene encoding any immunogenic polypeptide, in, e.g.,bacterial, yeast, insect, reptile or mammalian cells using recombinantmethods well known in the art and described, for example in Sambrook etal., Molecular Cloning: A Laboratory Manual, Cold Spring HarborLaboratory, New York (1992) and in Ansubel et al., Current Protocols inMolecular Biology, John Wiley and Sons, Baltimore, Md. (1998). A numberof genes encoding surface antigens from viral, bacterial and protozoanpathogens have been successfully cloned, expressed and used as antigensfor vaccine development. For example, the major surface antigen ofhepatitis B virus, HbsAg, the b subunit of choleratoxin, the enterotoxinof E. coli, the circumsporozoite protein of the malaria parasite, and aglycoprotein membrane antigen from Epstein-Barr virus, as well as tumorcell antigens, have been expressed in various well known vector/hostsystems, purified and used in vaccines.

A vaccine formulation containing cyclic di-nucleotide or STING activeagents may advantageously contain other vaccine adjuvants and carriers.These carriers and adjuvants include, but are not limited to, ionexchange resins, alumina, aluminum stearate, lecithin, serum proteins,such as human serum albumin, buffer substances such as phosphates,glycine, sorbic acid, potassium sorbate, partial glyceride mixtures ofsaturated vegetable fatty acids, phosphate buffered saline solution,water, emulsions (e.g. oil/water emulsion), salts or electrolytes suchas protamine sulfate, disodium hydrogen phosphate, potassium hydrogenphosphate, sodium chloride, zinc salts, colloidal silica, magnesiumtrisilicate, polyvinyl pyrrolidone, cellulose-based substances andpolyethylene glycol.

Any convenient method for determining if a vaccine compound orformulation induces an innate, humoral, cell-mediated, or anycombination of these types of immune response may be employed. Forexample, the ability of a vaccine compound or formulation to induce aninnate immune response through STING can be determined using methodsdescribed herein as well as other methods. Such methods for detecting aninnate immune response can be generally performed within hours ofvaccine administration. The ability of a vaccine compound or formulationto induce a humoral response can be determined by measuring the titer ofantigen-specific antibodies in an animal primed with the vaccine andboosted with the antigen, or determining the presence of antibodiescross-reactive with an antigen by ELISA, Western blotting or otherwell-known methods. Cellular immune responses can be determined, forexample, by measuring cytotoxic T cell response to antigen using avariety of methods, such as, e.g., FACS sorting, and other methods wellknown in the art. Methods of detecting humoral and cellular immuneresponses can be generally performed days or weeks after vaccineadministration.

Cyclic-Di-Nucleotides

In another aspect, provided herein are 2′-5′ phosphodiester linkagecontaining cyclic-di-nucleotides. As used herein, “cyclic-di-nucleotide”refers to a compound containing two nucleosides (i.e., a first andsecond nucleoside), wherein the 2′ or 3′ carbon of each nucleoside islinked to the 5′ carbon of the other nucleoside by a phosphodiesterbond. Therefore, a 2′-5′ phosphodiester linkage containingcyclic-di-nucleotide refers to a cyclic-di-nucleotide, wherein the 2′carbon of at least one of the nucleosides is linked to the 5′ carbon ofthe other nucleoside. As discussed herein, 2′-5′ phosphodiester linkagecontaining cyclic-di-nucleotides can be used in practicing the methodsdescribed herein for increasing production of a type I interferon in acell or subject. As used herein a “cyclic-di-nucleotide” also includesall of the stereoisomeric forms of the cyclic-di-nucleotides describedherein.

As used herein, a “nucleoside” refers to a composition containing anitrogenous base covalently attached to a sugar (e.g., ribose ordeoxyribose) or an analog thereof. Examples of nucleosides include, butare not limited to cytidine, uridine, adenosine, guanosine, thymidineand inosine. In some embodiments, the nucleoside contains a deoxyribosesugar. Analogs of nucleosides include, but are not limited todexoyadenosine analogues (e.g., Didanosine and Vidarabine);deoxycytidine analogues (e.g., Cytarabine, Ematricitabine, Lamivudine,and Zalcitabine); deoxyguanosine analogues (Abacavir and Entecavir);(deoxy-) thymidine analogues (e.g., Stavudine, Telbivudine, andZidovudine); and deoxyuridine alaogues (e.g., Idoxuridine andTrifluridine).

While not being bound by any particular theory of operation, and asshown in the examples below, cyclic-di-nucleotides can increase type-IIFN production in a cell. In certain embodiments, cyclic-di-nucleotidesincrease type-I IFN production through a mechanism that involvesstimulator of interferon genes (STING).

Cyclic-di-nucleotides include those specifically described herein aswell as isoforms (e.g., tautomers) of those specifically describedherein that can be used in practicing the subject methods.Cyclic-di-nucleotides can be obtained using any suitable method. Forexample, cyclic-di-nucleotides may be made by chemical synthesis usingnucleoside derivatives as starting material. Cyclic-di-nucleotides canalso be produced by in vitro synthesis, using recombinant purified cGAMPsynthase (cGAS), as described in the Experimental Section below.Moreover, the structures of such cyclic-di-nucleotides can be confirmedusing NMR analysis.

Cyclic-di-nucleotides provided herein can be described by the followingnomenclature: cyclic[X₁(A-5′)pX₂(B-5′)p], wherein X₁ and X₂ are thefirst and second nucleoside, A is the carbon of the first nucleoside(e.g., 2′ or 3′ position) that is linked to the 5′ carbon of the secondnucleoside via a phosphodiester bond and B is the carbon of the secondnucleoside (e.g., 2′ or 3′ position) that is linked to the 5′ carbon ofthe first nucleoside by a phosphodiester bond. For instance, based onthis nomenclature, cyclic[G(2′-5′)pA(3′-5′)p] has the following formula:

In certain embodiments, the cyclic-di-nucleotide contains a 2′-5′phosphodiester bond. In particular embodiments, the cyclic-di-nucleotidefurther contains a 3′-5′ phosphodiester bond (e.g.,cyclic[X₁(2′-5′)pX₂(3′-5′)p] or cyclic[X₁(3′-5′)pX₂(2′-5′)p]). In otherembodiments, the cyclic-di-nucleotide contains two 2′-5′ phosphodiesterbonds (cyclic[X₁(2′-5′)pX₂(2′-5′)p]).

In certain embodiments, the cyclic-di-nucleotide is:

cyclic[A(2′-5′)pA2′-5′)p];

cyclic[T(2′-5′)pT(2′-5′)p];

cyclic[G(2′-5′)pG(2′-5′)p];

cyclic[C(2′-5′)pC(2′-5′)p]; or

cyclic[U(2′-5′)pU(2′-5′)p].

In certain embodiments, the cyclic-di-nucleotide is:

cyclic[A(2′-5′)pA(3′-5′)p];

cyclic[T(2′-5′)pT(3′-5′)p];

cyclic[G(2′-5′)pG(3′-5′)p];

cyclic[C(2′-5′)pC(3′-5′)p];

cyclic[U(2′-5′)pU(3′-5′)p];

cyclic[A(2′-5′)pT(3′-5′)p];

cyclic[T(2′-5′)pA(3′-5′)p];

cyclic[A(2′-5′)pG(3′-5′)p];

cyclic[G(2′-5′)pA(3′-5′)p];

cyclic[A(2′-5′)pC (3′-5′)p];

cyclic[C(2′-5′)pA(3′-5′)p];

cyclic[A(2′-5′)pU(3′-5′)p];

cyclic[U(2′-5′)pA(3′-5′)p];

cyclic[T(2′-5′)pG(3′-5′)p];

cyclic[G(2′-5′)pT(3′-5′)p];

cyclic[T2′-5′)pC(3′-5′)p];

cyclic[C(2′-5′)pT(3′-5′)p];

cyclic[T(2′-5′)pU(3′-5′)p];

cyclic[U(2′-5′)pT(3′-5′)p];

cyclic[G(2′-5′)pC(3′-5′)p];

cyclic[C2′-5′)pG(3′-5′)p];

cyclic[G(2′-5′)pU(3′-5′)p];

cyclic[U(2′-5′)pG(3′-5′)p];

cyclic[C(2′-5′)pU(3′-5′)p]; or

cyclic[U(2′-5′)pC(3′-5′)p].

In certain embodiments, the cyclic-di-nucleotide has the followingformula:

wherein X and Y can be any organic molecule including a nitrogenousbase. As used herein a “nitrogenous base” refers to nitrogen-containingmolecules having the chemical properties of a base including, but notlimited to, pyrimidine derivatives (e.g., cytosine, thymine, and uracil)and purine derivatives (e.g., adenine and guanine), as well assubstituted pyrimidine and purine derivatives, pyrimidine and purineanalogs, and their tautomers. In certain embodiments, X and Y are eachone of the following:

In certain embodiments, the cyclic-di-nucleotide has the followingformula (cyclic[G(2′5′)pA(3′5′)p]):

In certain embodiments, the cyclic-di-nucleotide has the followingformula (cyclic[G(3′5′)pA(2′5′)p]):

In other embodiments, the cyclic-di-nucleotide has the following formulacyclic[G(2′5′)pA(2′5′)p]:

In other embodiments, the cyclic-di-nucleotide has the following formulacyclic[A(2′5′)pA(3′5′)p]:

In yet other embodiments, the cyclic-di-nucleotide has the followingformula cyclic[G(2′5′)pG(3′5′)p]:

In certain embodiments, the cyclic-di-nucleotide has the followingformula cyclic[A(2′5′)pA(2′5′)p]:

In certain embodiments, the cyclic-di-nucleotide has the followingformula cyclic[G(2′5′)pG(2′5′)p]:

In certain embodiments, the cyclic-di-nucleotide has one of thefollowing formulas:

wherein R is any amino acid side chain.

Pharmaceutical Compositions

In another aspect, provided herein is a pharmaceutical composition thatcontains any of the cyclic-di-nucleotide active agents provided hereinand a pharmaceutically acceptable carrier. In certain embodiments of thepharmaceutical composition, the cyclic-di-nucleotide active agent is oneor more cyclic-di-nucleotides.

The term “pharmaceutically acceptable” means approved by a regulatoryagency of the Federal or a state government or listed in the U.S.Pharmacopeia or other generally recognized foreign pharmacopeia for usein animals, and more particularly in humans. The term “carrier” refersto a diluent, adjuvant, excipient, or vehicle with which themitochondrial transport protein inhibitor is administered. Suchpharmaceutical carriers can be, for example, sterile liquids, such assaline solutions in water and oils, including those of petroleum,animal, vegetable or synthetic origin, such as peanut oil, soybean oil,mineral oil, sesame oil and the like. A saline solution is a preferredcarrier when the pharmaceutical composition is administeredintravenously. Saline solutions and aqueous dextrose and glycerolsolutions can also be employed as liquid carriers, particularly forinjectable solutions. Suitable pharmaceutical excipients include starch,glucose, lactose, sucrose, gelatin, malt, rice, flour, chalk, silicagel, sodium stearate, glycerol monostearate, talc, sodium chloride,dried skim milk, glycerol, propylene glycol, water, ethanol and thelike. The composition, if desired, can also contain minor amounts ofwetting or emulsifying agents, or pH buffering agents. Thesecompositions can take the form of solutions, suspensions, emulsion,tablets, pills, capsules, powders, sustained-release formulations andthe like. The composition can be formulated as a suppository, withtraditional binders and carriers such as triglycerides. The inhibitorscan be formulated as neutral or salt forms. Pharmaceutically acceptablesalts include those formed with free amino groups such as those derivedfrom hydrochloric, phosphoric, acetic, oxalic, tartaric acids, etc., andthose formed with free carboxyl groups such as those derived fromsodium, potassium, ammonium, calcium, ferric hydroxides, isopropylamine,triethylamine, 2-ethylamino ethanol, histidine, procaine, etc. Examplesof suitable pharmaceutical carriers are described in “Remington'sPharmaceutical Sciences” by E. W. Martin, hereby incorporated byreference herein in its entirety. Such compositions will contain atherapeutically effective amount of the mitochondrial transport protein(e.g., a Miro protein, a TRAK protein, or Khc) inhibitor, preferably inpurified form, together with a suitable amount of carrier so as toprovide the form for proper administration to the patient. Theformulation should suit the mode of administration.

The pharmaceutical composition can also include any of a variety ofstabilizing agents, such as an antioxidant for example. When thepharmaceutical composition includes a polypeptide, the polypeptide canbe complexed with various well-known compounds that enhance the in vivostability of the polypeptide, or otherwise enhance its pharmacologicalproperties (e.g., increase the half-life of the polypeptide, reduce itstoxicity, enhance solubility or uptake). Examples of such modificationsor complexing agents include sulfate, gluconate, citrate and phosphate.The polypeptides of a composition can also be complexed with moleculesthat enhance their in vivo attributes. Such molecules include, forexample, carbohydrates, polyamines, amino acids, other peptides, ions(e.g., sodium, potassium, calcium, magnesium, manganese), and lipids.

Further guidance regarding formulations that are suitable for varioustypes of administration can be found in Remington's PharmaceuticalSciences, Mace Publishing Company, Philadelphia, Pa., 17th ed. (1985).For a brief review of methods for drug delivery, see, Langer, Science249:1527-1533 (1990).

The components used to formulate the pharmaceutical compositions arepreferably of high purity and are substantially free of potentiallyharmful contaminants (e.g., at least National Food (NF) grade, generallyat least analytical grade, and more typically at least pharmaceuticalgrade). Moreover, compositions intended for in vivo use may be sterile.To the extent that a given compound must be synthesized prior to use,the resulting product is typically substantially free of any potentiallytoxic agents, particularly any endotoxins, which may be present duringthe synthesis or purification process. Compositions for parentaladministration are also sterile, substantially isotonic and made underGMP conditions.

The pharmaceutical composition can be formulated for intravenous, oral,via implant, transmucosal, transdermal, intramuscular, intrathecal, orsubcutaneous administration. In some embodiments, the pharmaceuticalcomposition is formulated for intravenous administration. In otherembodiments, the pharmaceutical composition is formulated forsubcutaneous administration. The following delivery systems, whichemploy a number of routinely used pharmaceutical carriers, are onlyrepresentative of the many embodiments envisioned for administering theinstant compositions.

Injectable drug delivery systems include solutions, suspensions, gels,microspheres and polymeric injectables, and can comprise excipients suchas solubility-altering agents (e.g., ethanol, propylene glycol andsucrose) and polymers (e.g., polycaprylactones and PLGAs). Implantablesystems include rods and discs, and can contain excipients such as PLGAand polycaprylactone. Osteopontin or nucleic acids of the invention canalso be administered attached to particles using a gene gun.

Oral delivery systems include tablets and capsules. These can containexcipients such as binders (e.g., hydroxypropylmethylcellulose,polyvinyl pyrilodone, other cellulosic materials and starch), diluents(e.g., lactose and other sugars, starch, dicalcium phosphate andcellulosic materials), disintegrating agents (e.g., starch polymers andcellulosic materials) and lubricating agents (e.g., stearates and talc).

Transmucosal delivery systems include patches, tablets, suppositories,pessaries, gels and creams, and can contain excipients such assolubilizers and enhancers (e.g., propylene glycol, bile salts and aminoacids), and other vehicles (e.g., polyethylene glycol, fatty acid estersand derivatives, and hydrophilic polymers such ashydroxypropylmethylcellulose and hyaluronic acid).

Dermal delivery systems include, for example, aqueous and nonaqueousgels, creams, multiple emulsions, microemulsions, liposomes, ointments,aqueous and nonaqueous solutions, lotions, aerosols, hydrocarbon basesand powders, and can contain excipients such as solubilizers, permeationenhancers (e.g., fatty acids, fatty acid esters, fatty alcohols andamino acids), and hydrophilic polymers (e.g., polycarbophil andpolyvinylpyrolidone). In one embodiment, the pharmaceutically acceptablecarrier is a liposome or a transdermal enhancer.

In certain embodiments, the pharmaceutical composition containing thecyclic-di-nucleotide active agent is formulated to cross the blood brainbarrier (BBB). One strategy for drug delivery through the blood brainbarrier (BBB) entails disruption of the BBB, either by osmotic meanssuch as mannitol or leukotrienes, or biochemically by the use ofvasoactive substances such as bradykinin. A BBB disrupting agent can beco-administered with the therapeutic compositions when the compositionsare administered by intravascular injection. Other strategies to gothrough the BBB may entail the use of endogenous transport systems,including caveoil-1 mediated transcytosis, carrier-mediated transporterssuch as glucose and amino acid carriers, receptor-mediated transcytosisfor insulin or transferrin, and active efflux transporters such asp-glycoprotein. Active transport moieties may also be conjugated to thetherapeutic compounds for use in the invention to facilitate transportacross the endothelial wall of the blood vessel. Alternatively, drugdelivery of the ND pharmaceutical composition behind the BBB may be bylocal delivery, for example by intrathecal delivery, e.g., through anOmmaya reservoir (see, e.g., U.S. Pat. Nos. 5,222,982 and 5,385,582,incorporated herein by reference); by bolus injection, e.g., by asyringe, e.g., intravitreally or intracranially; by continuous infusion,e.g., by cannulation, e.g., with convection (see, e.g., US ApplicationNo. 20070254842, incorporated here by reference); or by implanting adevice upon which the inhibitor pharmaceutical composition has beenreversably affixed (see e.g., US Application Nos. 20080081064 and20090196903, incorporated herein by reference).

In certain embodiments, the pharmaceutical composition containing thecyclic-di-nucleotide or STING active agents is formulated in a deliveryvehicle, e.g., to enhance cytosolic transport. Any convenient protocolmay be employed to facilitate delivery of the cyclic-di-nucleotideactive agent across the plasma membrane of a cell and into the cytosol.In certain embodiments, the cyclic-di-nucleotide or STING active agentsand an antigen effective for use in a vaccine may be formulated togetherto be delivered by the same delivery vehicle in the pharmaceuticalcomposition.

In some instances, the cyclic-di-nucleotide or STING active agents maybe encapsulated in a delivery vehicle comprising liposomes in thepharmaceutical composition. Methods of using liposomes for drug deliveryand other therapeutic uses are known in the art. See, e.g., U.S. Pat.No. 8,329,213, U.S. Pat. No. 6,465,008, U.S. Pat. No. 5,013,556, USApplication No. 20070110798, and Andrews et al., Mol Pharm 2012 9:1118,which are incorporated herein by reference. Liposomes may be modified torender their surface more hydrophilic by adding polyethylene glycol(“pegylated”) to the bilayer, which increases their circulation time inthe bloodstream. These are known as “stealth” liposomes and areespecially useful as carriers for hydrophilic (water soluble) molecules,such as the cyclic-di-nucleotide active agents.

In certain embodiments, nano- or microparticles made from biodegradablematerials such as poly(lactic acid), poly(γ-glutamic acid),poly(glycolic acid), polylactic-co-glycolic acid. Polyethylenimine, oralginate microparticles, and cationic microparticles, includingdedrimers, such as cyclodextrins, may be employed as delivery vehiclesfor cyclic-di-nucleotide or STING active agents to promote cellularuptake. See, e.g., U.S. Pat. No. 8,187,571, Krishnamachari et al., AdvDrug Deliv Rev 2009 61:205, Garzon et al., 2005 Vaccine 23:1384,incorporated herein by reference.

In another embodiment, photochemical internalization may be employed toenhance cytosolic uptake of cyclic-di-nucleotide or STING active agents.See, e.g., US Application No. 20120226217, incorporated herein byreference. In such embodiments, the cyclic-di-nucleotide or STING activeagents may be co-adiminstered with a photosensitizing agent. Then,exposure of the target cells to light of a specific wavelength triggersinternalization of the cyclic-di-nucleotide or STING active agents.

In certain embodiments, the delivery vehicle for delivering thecyclic-di-nucleotide or STING active agents can also be targetingdelivery vehicles, e.g., a liposome containing one or more targetingmoieties or biodistribution modifiers on the surface of the liposome. Atargeting moiety can be any agent that is capable of specificallybinding or interacting with a desired target.

The specific binding agent can be any molecule that specifically bindsto a protein, peptide, biomacromolecule, cell, tissue, etc. that isbeing targeted (e.g., a protein peptide, biomacromolecule, cell, tissue,etc. wherein the cyclic-di-nucleotide or STING active agent exerts itsdesired effect). Depending on the nature of the target site, thespecific binding agent can be, but is not limited to, an antibodyagainst an epitope of a peptidic analyte, or any recognition molecule,such as a member of a specific binding pair. For example, suitablespecific binding pairs include, but are not limited to: a member of areceptor/ligand pair; a ligand-binding portion of a receptor; a memberof an antibody/antigen pair; an antigen-binding fragment of an antibody;a hapten; a member of a lectin/carbohydrate pair; a member of anenzyme/substrate pair; biotin/avidin; biotin/streptavidin;digoxin/antidigoxin; a member of a peptide aptamer binding pair; and thelike.

In certain embodiments, the specific binding moiety includes anantibody. An antibody as defined here may include fragments ofantibodies which retain specific binding to antigen, including, but notlimited to, Fab, Fv, scFv, and Fd fragments, chimeric antibodies,humanized antibodies, single-chain antibodies, and fusion proteinscomprising an antigen-binding portion of an antibody and a non-antibodyprotein. The antibodies may also include Fab′, Fv, F(ab′)₂, and or otherantibody fragments that retain specific binding to antigen.

In certain embodiments, the targeting moiety is a binding agent thatspecifically interacts with a molecule expressed on a tumor cell or animmune cell (e.g., CD4, CD8, CD69, CD62L, and the like), such that thetargeting delivery vehicle containing the cyclic-di-nucleotide or STINGactive agents is delivered to the site of a tumor or to specific immunecells.

Where desired, any combinations of the above listed delivery vehiclesmay be used advantageously to enhance delivery of thecyclic-di-nucleotide or STING active agents to the target cells.

Components of the pharmaceutical composition can be supplied eitherseparately or mixed together in unit dosage form, for example, as a drylyophilized powder or water free concentrate. Where the composition isto be administered by infusion, it can be dispensed with an infusionbottle containing sterile pharmaceutical grade water or saline. Wherethe composition is administered by injection, an ample of sterile waterfor injection or saline can be provided so that the ingredients may bemixed prior to administration.

In some embodiments, the pharmaceutical composition is supplied as a drysterilized lyophilized powder that is capable of being reconstituted tothe appropriate concentration for administration to a subject. In someembodiments, the pharmaceutical composition is supplied as a water freeconcentrate. In some embodiments, the pharmaceutical composition issupplied as a dry sterile lyophilized powder at a unit dosage of atleast 0.5 mg, at least 1 mg, at least 2 mg, at least 3 mg, at least 5mg, at least 10 mg, at least 15 mg, at least 25 mg, at least 30 mg, atleast 35 mg, at least 45 mg, at least 50 mg, at least 60 mg, or at least75 mg.

Solutions, suspensions and powders for reconstitutable delivery systemsinclude vehicles such as suspending agents (e.g., gums, xanthans,cellulosics and sugars), humectants (e.g., sorbitol), solubilizers(e.g., ethanol, water, PEG and propylene glycol), surfactants (e.g.,sodium lauryl sulfate, Spans, Tweens, and cetyl pyridine), preservativesand antioxidants (e.g., parabens, vitamins E and C, and ascorbic acid),anti-caking agents, coating agents, and chelating agents (e.g., EDTA).

In some embodiments, the pharmaceutical composition is formulated as asalt form. Pharmaceutically acceptable salts include those formed withanions such as those derived from hydrochloric, phosphoric, acetic,oxalic, tartaric acids, etc., and those formed with cations such asthose derived from sodium, potassium, ammonium, calcium, ferrichydroxides, isopropylamine, triethylamine, 2-ethylamino ethanol,histidine, procaine, etc.

In certain embodiments, the pharmaceutical composition contains aprodrug derivative of any of the cyclic-di-nucleotide or STING activeagents provided herein. Such prodrugs can be subsequently converted toan active form of the cyclic-di-nucleotide or STING active agent in thebody of the subject administered the pharmaceutical composition.

Kits

Kits with unit doses of the subject cyclic-di-nucleotide active agents,e.g., one or more cyclic-di-nucleotides, e.g., in oral or injectabledoses, are provided. In the subject kits, the one or more components arepresent in the same or different containers, as may be convenient ordesirable.

In addition to the containers containing the unit doses will beinstructions describing the use and attendant benefits of thecyclic-di-nucleotide in treating a pathological condition of interest.Instructions may be provided in a variety of different formats. Incertain embodiments, the instructions may include complete protocols forpracticing the subject methods or means for obtaining the same (e.g., awebsite URL directing the user to a webpage which provides theinstructions), where these instructions may be printed on a substrate,where substrate may be one or more of: a package insert, the packaging,reagent containers and the like.

The following examples are put forth so as to provide those of ordinaryskill in the art with a complete disclosure and description of how tomake and use the present invention, and are not intended to limit thescope of what the inventors regard as their invention nor are theyintended to represent that the experiments below are all or the onlyexperiments performed. Efforts have been made to ensure accuracy withrespect to numbers used (e.g., amounts, temperature, etc.) but someexperimental errors and deviations should be accounted for. Unlessindicated otherwise, parts are parts by weight, molecular weight isweight average molecular weight, temperature is in degrees Centigrade,and pressure is at or near atmospheric.

EXPERIMENTAL I. Results and Discussion

Recognition of pathogen-derived nucleic acid is a major mechanism bywhich innate immune responses are initiated in mammals (Barbalat et al.,Annu Rev Immunol (2011) 29: 185). Several families of germ-line encodednucleic acid sensors have been described, including the Toll-likereceptors (TLRs) and RIG-1-like receptors (RLRs)(Palm et al., ImmunolRev (2009) 227: 221; Takeuchi et al., Cell (2010) 140: 805). Uponbinding nucleic acids, these sensors initiate signaling cascades thatlead to the production of cytokines and other immune effector proteinsthat provide host defense.

The cytosolic presence of foreign double-stranded (ds) DNA triggers apotent antiviral response dominated by the production of type Iinterferons (IFNs) (Ishii et al., Nat. Immunol. (2006) 7: 40; Stetson etal., Immunity (2006) 24: 93). However, the molecular mechanism linkingdsDNA to interferon production has not been well characterized (Burdette& Vance, Nat. Immunol. (2013) 14: 19). A host protein, STING, wasidentified and shown to be required for the IFN response to cytosolicdsDNA (Ishikawa & Barber, Nature (2008) 455: 674; Ishikawa et al.,Nature (2009) 461: 788; Sun et al., Proc Natl Acad Sci USA (2009) 106:8653; and Zhong et al., Immunity (2008) 29: 538). STING was also shownto be required for the interferon response to bacterially-derived secondmessengers called cyclic-di-nucleotides (CDNs)(Jin et al., J Immunol(2011) 187: 2595; and Sauer et al., Infect Immun (2011) 79: 688). CDNsare secreted or released into the cytosol by certain bacterial pathogens(Woodward et al., Science (2010) 328: 1703) and bind directly to STING(Burdette et al., Nature (2011) 478: 515). Interestingly, however, amutant (R231A) allele of mouse STING was identified that abolishedresponsiveness to CDNs but did not appreciably affect the interferonresponse to cytosolic DNA (Id). In contrast, 293T cells expressingwild-type mouse STING are responsive to CDNs but not to dsDNA. Thus,although the IFN responses to cytosolic CDNs and dsDNA both requireSTING, the responses to these chemically distinct ligands can begenetically uncoupled.

Based on two studies (Sun, et al., Science (2013) 339: 786; and Wu etal., Science (2013) 339: 826), it was proposed that the cytosolicpresence of dsDNA leads to the production of a CDN, cyclic-GMP-AMP(cGAMP), by a DNA-dependent sensor called cGAMP synthase (cGAS). cGAMPwas shown to bind and activate STING. However, it remained unclear howthe STING R231A mutant could still initiate responses to dsDNA despitelacking responsiveness to CDNs. Therefore, the mechanism by which cGASactivates STING was investigated.

Previous studies (Sauer et al., Burdette et al.) focused primarily onmouse STING and it was not yet clear whether human STING could respondto CDNs (Conlon et al., J Immunol, (2013) 190: 5216). As previouslyreported (Sun et al., Wu et al.) it was found that the human THP-1 cellline responded robustly to CDNs in a manner dependent on STING (FIG. 1A,B). hSTING was cloned from THP-1 cells and compared its amino acidsequence to the previously widely studied reference allele(NP_(—)938023.1; denoted here as hSTING^(REF)) (7) (FIG. 2). It wasfound that hSTING^(REF) and hSTING^(THP-1) differ at four amino acidpositions. Notably, hSTING^(REF) encodes a histidine (H) at amino acidposition 232, whereas hSTING^(THP-1) encodes an arginine (R) at thisposition, which corresponds to R231 in mSTING that is critical forresponsiveness to CDNs. Therefore, the functionality of individualhSTING alleles were tested by expressing these alleles in 293T cellsthat lack endogenous STING (Burdette et al.). As previously observed(Burdette et al.), overexpression of mSTING in 293T cells is sufficientto induce ligand-independent activation of an IFN-luciferase reporterconstruct; however, transfection of 293T cells with lower amounts ofmSTING renders the cells responsive to CDNs. Likewise, 293T cellsexpressing hSTING^(THP-1) were responsive to CDN stimulation. Incontrast, cells expressing hSTING^(REF) were poorly or non-responsive(FIG. 1C). Interestingly, it was observed that three recent crystalstructures of STING bound to cyclic-di-GMP were of the poorly-responsivehSTING^(REF) protein (Huang, et al., Nature Struct. & Mol. Biol. (2012)19: 728; Ouyang et al., Immunity (2012) 36: 1073; Yin et al., Mol Cell(2012) 46: 735).

293T cells are not responsive to stimulation by dsDNA, presumably due tolack of expression of cGAS (Sun et al.) or perhaps other DNA sensors.Therefore, to test whether the hSTING variants could respond to DNAstimulation, STING-null (‘goldenticket’)(Sauer et al.), but (cGAS⁺)macrophages were transduced with hSTING expression vectors.Interestingly, even the hSTING^(REF) variant that is non-responsive toCDNs conferred responsiveness to dsDNA (FIG. 1D). hSTING^(REF) thereforephenocopies the R231A mutant of mouse STING, previously described thatuncouples responsiveness to CDNs and dsDNA (Burdette et al.). Like themSTING^(R231A) variant, hSTING^(REF) still bound to CDNs (FIG. 1E)(Huang et al., Ouyang et al., and Yin et al.), indicating that thisallele is compromised at a step downstream of CDN binding.

Consistent with the above results with hSTING alleles, an R231H mutantof mSTING was poorly responsive to CDNs, as were R232A or R232H variantsof hSTING^(THP) (FIG. 3A). It was therefore concluded that arginine231/232 is critical for responsiveness to CDNs in mouse/human STING.Introduction of an H232R mutation in hSTING^(REF), however was notsufficient to restore the responsiveness to CDNs; indeed, it wasobserved that a second substitution (G230A) was also required (FIG. 4).Again, all the variant STING alleles that were tested boundcyclic-di-GMP, consistent with the fact that residues 230 and 232 arelocated in loops that cover but do not form the CDN binding pocket (FIG.3B) (Burdette & Vance).

Importantly, mSTING^(R231A) was also non-responsive to chemicallysynthesized cGAMP (FIG. 1F) (Kellenberger, et al., J Am Chem. Soc.(2013). 135:4906). This raised the question of whether R231A/R232Hvariants of STING would be responsive to the cGAS enzyme that isbelieved to activate STING via production of cGAMP. It was found thathuman or mouse cGAS expression was sufficient to robustly activatehSTING^(REF) and mSTING^(R231A) variants, even at very low levels ofcGAS expression (FIG. 5A). Several explanations were considered for thisresult. One explanation is that the response is due simply tooverexpression of the synthase in mammalian cells; however,overexpression of a bacterial enzyme that produces cGAMP (DncV from V.cholerae) (Davies, Cell (2012)149: 358) did not activate hSTING^(REF) ormSTING^(R231A) but did activate wild-type mSTING and hSTING^(THP-1)(FIG. 5B). An alternative hypothesis is that cGAS might physicallyinteract with STING and thereby activate STING in a manner independentof cGAMP production. However, this explanation also appears to beincorrect. As previously demonstrated (Sun et al.), overexpression ofcatalytically dead mutants of human or mouse cGAS failed to activateSTING (GS>AA; FIG. 2A), arguing that cGAS signaling depends on theproduction of a second messenger rather than on a direct physicalinteraction with STING. To confirm this interpretation, the enzymaticproduct of cGAS was produced by providing ATP, GTP and dsDNA to purifiedrecombinant cGAS in vitro. As a negative control, dsDNA (required tostimulate cGAS activity) was omitted from a parallel reaction. Theresulting cGAS products were then purified and transfected into 293Tcells expressing STING variants. In contrast to synthetic cGAMP, thecGAS product was able to activate hSTING^(REF) and mSTING^(R231A) (FIG.5C). This experiment ruled out a model in which cGAS activateshSTING^(REF) via a direct physical interaction.

It was therefore hypothesized that the actual product of cGAS might notbe a canonical CDN as previously proposed (Sun et al., Wu et al.). Itwas hypothesized that cGAS might produce a novel CDN containing 2′-5′phosphodiester bond(s) that would be able to stimulate variant STINGalleles. Importantly, such a non-canonical CDN would be of an identicalmass to the canonical 3′-5′ phosphodiester-linked CDNs and the twoproducts would not, therefore, have been easy to distinguish bypreviously published mass spectrometric analyses of the cGAS product(Sun et al., Wu et al.) To test this hypothesis radiolabelled α³²P-GTPor α³²P-ATP were provided to recombinant purified cGAS or V. choleraeDncV and the products were analyzed by thin-layer chromatography. Asreported previously, DncV produced some c-di-AMP if provided only ATP,and some c-di-GMP if provided only GTP, but preferred to make cGAMP whenprovided both ATP and GTP (Davies, et al., Cell (2012)149: 358). (FIG.6A). Interestingly, cGAS required both ATP and GTP substrates and theresulting product migratessignificantly differently than any of thecanonical CDNs produced by DncV,

suggesting that cGAS produces a novel non-canonical CDN (FIG. 6A).

cGAS and DncV products were analyzed by specific nuclease digestion. ThecGAS product was partially cleaved by nuclease P1, which selectivelydigests 3′-5′ phosphodiester linkages, suggesting that the cGAS productcontains at least one 3′-5′ phosphodiester linkage (FIG. 6B). However,nuclease P1 digestion was incomplete as it did not lead to generation ofGMP, in contrast to treatment of the cGAS product with snake venomphosphodiesterase, which cleaved both 2′-5′ and 3′-5′ phosphodiesterlinkages (FIG. 3B). This suggests that the cGAS product contains a 2′-5′phosphodiester linkage.

CDNs have been proposed to be useful as vaccine adjuvants orimmunotherapeutics (Chen, et al., Vaccine (2010) 28:3080). A syntheticSTING activator, DMXAA, has been tested in human clinical trials as anovel chemotherapeutic agent. Unfortunately, DMXAA was not found to beefficacious in humans, likely because it is unable to stimulate hSTING(Conlon et al.). In this context, our results are significant as theyindicate that non-canonical 2′-5′ linked CDNs function as potentpan-agonists of diverse STING variants, including those variants thatare only poorly responsive to canonical CDNs or DMXAA.

II. Materials and Methods A. Mice and Cell Lines

THP-1 cells were grown in RPMI 1640 supplemented with 10% FBS,penicillin-streptomycin and L-glutamine. HEK293T cells were grown inDMEM supplemented with 10% FBS, penicillin-streptomycin and L-glutamine.Gp2 retroviral packaging cell lines were maintained in DMEM supplementedwith 10% FBS, penicillin-streptomycin and L-glutamine. Animal protocolswere approved by the University of California, Berkeley Animal Care andUse Committee.

B. STING Knockdown

Knockdown of human STING (clone ID NM_(—)198282.1-90151c1) was achievedusing pLKO.1 (The RNAi Consortium). The sequence for knockdown of humanSTING is 5′-GCA GAG CTA TTT CCT TCC ACA (SEQ ID NO:07) which correspondto 5′-CCG GGC AGA GCT ATT TCC TTC CAC ACT CGA GTG TGG AAG GAA ATA GCTCTG CTT TTT G (SEQ ID NO:08) forward oligo and 5′-AAT TCA AAA AGC AGAGCT ATT TCC TTC CAC ACT CGA GTG TGG AAG GAA ATA GCT CTG C (SEQ ID NO:09)reverse oligo. Oligos were annealed and cloned into Agel and EcoRIdigested pLKO.1 (Addgene) and retrovirally transduced into THP-1 cellsin parallel with scramble shRNA control constructs. Stable cell lineswere selected with puromycin. THP-1 cells were differentiated with 1μg/mL PMA for 24 hours. Cells were allowed to rest for 24 hours and thenrestimulated for 6 hours with the indicated ligands. IFN induction wasmeasured by qRT-PCR as described below.

C. Cell Stimulation and Reagents

Bone marrow macrophages and HEK293T cells were stimulated usingLipofectamine 2000 (Invitrogen). Unless otherwise specified,cyclic-di-GMP, cyclic-di-AMP, polyl:C and Vaccinia Virus 70 mer DNA wasprepared as described previously (Burdette et al.) and used at similarconcentrations. Sendai virus was purchased from Charles RiverLaboratories. cGAMP was synthesized as previously described(Kellenberger et al).

D. Cloning, Mutagenesis and Plasmids

The THP-1 STING allele was amplified from cDNA using 5′ hSTINGHindIII(5′-ATCGAA GCT TCC ACC ATG CCC CAC TCC AGC CTG) (SEQ ID NO:10)and 3′ hSTING NotI (5′-ATC GGC GGC CGC TCA GGC ATA GTC AGG CAC GTC ATAAGG ATA AGA GAA ATC CGT GCG GAG AG) (SEQ ID NO:11). Resulting PCRproduct was cloned into pCDNA3 using HindIII/NotI digestion. THP-1 STINGwas amplified and cloned into MSCV2.2 using the 3′ primer listed aboveand 5′ hSTING XhoI (5′-ATC GCT CGA GCC ACC ATG CCC CAC TCC AGC CTG) (SEQID NO:12) and XhoI/NotI digestion. IFN-luciferase, TK-Renilla and mouseSTING plasmids were used as previously described (Burdette et al.).Mutations in human STING were introduced using Quikchange Site DirectedMutagenesis Kit (Stratagene). cDNA clones corresponding to mouse andhuman cGAS (MGC Fully Sequenced Human MB21D1 cDNA, Accession:BC108714.1, Clone ID: 6015929; EST Fully Sequenced Mouse E330016A19RikcDNA, Accession: BC145653.1, Clone ID: 40130956) were obtained from OpenBiosystems and correspond to those described previously (Sun et al., Wuet al.). Mouse cGAS was amplified from cDNA clones with an N-terminalflag tag with forward oligo 5′-mcGAS-KpnI (5′-ATC GGG TAC CCC ACC ATGGAT TAC AAG GAT GAC GAT GAC AAG GAA GAT CCG CGT AGA AGG) (SEQ ID NO:13)and reverse oligo 3′-mcGAS-NotI (5′-ATC GGC GGC CGC TCA AAG CTT GTC AAAAAT TGG) (SEQ ID NO:14). Likewise, hcGAS was amplified with forwardoligo 5′-hcGAS-flag-KpnI (5′-ATC GGG TAC CCC ACC ATG GAT TAC AAG GAT GACGAT GAC AAG CAG CCT TGG CAC GGA AAG G) (SEQ ID NO:15) and reverse3′-hcGAS-NotI (5′ATC GGC GGC CGC TCA AAA TTC ATC AAA AAC TGG AAA C) (SEQID NO:16). Both PCR products were cloned into pCDNA3 at KpnI and NotIrestriction enzyme sites. DncV was amplified using DncV fwd BamHI(5′-GCA TGG ATC CGC CAC CAT GAC TTG GAA CTT TCA CCA G) (SEQ ID NO:17)and DncV rev NotI (5′-GCA TGC GGC CGC TCA GCC ACT TAC CAT TGT GCT GC)(SEQ ID NO:18) and cloned into pCDNA3 using BamHI and NotI. For cloninginto MSCV2.2, DncV was amplified using DncV fwd XhoI (5′-GCA TCT CGA GCCACC ATG ACT TGG AAC TTT CAC CAG) (SEQ ID NO:19) and DncV rev NotI.Resulting DNA was cloned into MSCV 2.2 digested with XhoI/NotI.Constructs for bacterial mcGAS overexpression were constructed asfollows. N terminal His6-SUMO tag amplified by PCR using His6 SUMO Nco(5′-TAA TAA GGA GAT ATA CCA TGG GCA GCA GCC) (SEQ ID NO:20) and His6SUMO Sal (5′-GAA TTC GTC GAC ACC AAT CTG TTC TCT GTG AGC) (SEQ ID NO:21)off of pCDF-Duet2 template (gift from M. Rape lab, UC-Berkeley) andcloned into pET28a using NcoI and SalI to make pET28a-H6SUMO. Fulllength mcGAS was PCR amplified from the mouse cDNA clone described aboveusing mcGAS fwd Sal (5′-GAT GTC GAC ATG GAA GAT CCG CGT AGA AGG ACG)(SEQ ID NO:22) and mcGAS rev Xho (5′-ATC CTC GAG TCA AAG CTT GTC AAA AATTGG AAA CC) (SEQ ID NO:23) and cloned into pET28a-H6SUMO using SalI andXhoI to make pET28a-H6SUMO-mcGAS that expresses full length mcGAS fusedto an N-terminal His6 SUMO tag.

E. Protein Purifications

WspR construct (pQE-WspR*) was a generous gift from Steve Lory(Harvard). WspR purification and c-di-GMP synthesis reactions werecarried out as previously described (Merighi, et al., Mol Microbiol(2007)65: 876). Overexpression strains and plasmids for DncV and mutantDncV were provided by J. Mekalanos. DncV protein was overexpressed andpurified as previously described (Davies et al.). Briefly, DncV proteinproduction was induced in mid-log phase for 3 h at 37° C. with 1 mMIPTG. Cells were lysed and DncV protein was purified under denaturingconditions. Cleared lysate was incubated with Ni-NTA and eluted in UreaElution buffer (2M Urea, 10 mM Tris pH=8.0, 150 mM NaCl, 250 mMImidazole). Eluted protein was dialyzed to 25 mM Tris-Cl, pH=7.5, 300 mMNaCl, 5 mM Mg(OAc)₂, 10% glycerol, 2 mM DTT. H6SUMO-mcGAS was expressedin Rosetta(DE3) pLysS cells by overnight induction with 0.5 mM IPTG at18° C. Cells were lysed into 50 mM Tris-Cl, pH=8, 300 mM NaCl, 20 mMImidazole, 5 mM BME and 0.2 mM PMSF by French Press. Cleared lysate wasincubated with Ni-NTA and bound protein was eluted with 20 mM Tris-Cl,pH=7.4, 150 mM NaCl, 300 mM Imidazole. Eluant was dialyzed to 20 mMTris-Cl, pH=7.4, 150 mM NaCl, 5 mM β-mercaptoethanol with 10% glycerol.Protein was flash frozen and stored at −80° C.

F. cGAS Product Purification and Structural Characterization

The cGAS product was purified using reverse-phase HPLC on an Agilent1260 Infinity HPLC equipped with an Agilent Polaris C18-A column (5 μm,250 mm×10 mm, 180 Å). Purification conditions include a 100% to 0%gradient of solvent A over 20 min at 50° C. and a flow rate of 5 mL/min,where solvent A is 100 mM ammonium acetate in water and solvent B isacetonitrile. Purified elution fractions were evaporated multiple timesin order to remove excess ammonia. Resonance assignments were made usingCOSY, ¹H-¹³C HSQC, NOESY, ¹H-¹³C HMBC, and 1H-³¹P HMBC. Characterizationof cGAS product: ¹H NMR (900 MHz, D2O, 50° C., δ): 8.44 (1H, s), 8.42(1H, s), 8.03 (1H, s), 6.31 (1H, s), 6.09 (1H, J=8 Hz, d), 5.75 (1H, m),5.18 (1H, m), 4.93 (1H, s), 4.74, 4.62, 4.59 (1H, J=12 Hz, d), 4.55 (1H,s), 4.38 (1H, m), 4.33 (1H, J=12 Hz, d), 4.28 (1H, J=12 Hz, d); 31P {¹Hdecoupled} NMR (600 MHz, D20, 50° C., δ): (all resonances aresinglets)-0.96, −1.86; HRMS (m/z): [M-H]-monoisotopic mass calculatedfor C₂₀H₂₄N₁₀O₁₃P₂, 673.0927. found, 673.0909. [M+Na 2H]-monoisotopicmass calculated for C₂₀H₂₄N₁₀O₁₃P₂, 695.0752. found, 695.0728.

G. Luciferase Assay

HEK293T cells were plated in TC-treated 96-well plates at 0.5%°-%106%cells°/0 ml-1. The next day, the cells were transfected with indicatedconstructs, together with IFN-β-firefly luciferase and TKRenillaluciferase reporter constructs. Following stimulation for 6% h with theindicated ligands, the cells were lysed in passive lysis buffer(Promega) for 5% min at 25° C. The cell lysates were incubated withfirefly luciferase substrate (Biosynth) and the Renilla luciferasesubstrate coelenterazine (Biotium), and luminescence was measured on aSpectraMax L microplate reader (Molecular Devices). The relative lfnbexpression was calculated as firefly luminescence relative to Renillaluminescence.

H. In Vitro Cyclic-Di-Nucleotide Synthesis

In vitro DncV reactions were carried out in 20 mM Tris-Cl, pH=8, 20Mg(OAc)2, 10% glycerol and 1 mM DTT, 0.1 mg/mL BSA. Reactions contained250 μM GTP, 250 μM ATP or 125 μM GTP and 125 μM ATP as indicated infigures. In addition, 33 nM α32P-GTP (3000Ci/mmol, Perkin-Elmer) or 33nM α32P-ATP (3000Ci/mmol, Perkin-Elmer) was included in reaction whereindicated. Reactions were started by addition of 1 μM purified DncVprotein. In vitro cGAS reactions were carried out in 40 mM Tris-Cl,pH=7.5, 100 mM NaCl, 10 mM MgCl2. Cold nucleotide and alpha-labeled GTPis at the same concentrations as in DncV reactions. Reactions werestarted by addition of 200 nM purified cGAS. Where indicated, herringtestes DNA (Sigma) was added to reactions at a final concentration of0.1 mg/mL. WspR reactions were performed as described previously (14).Reactions were incubated for 1 hour at 37° C., boiled for 5 min at 95°C., and spun for 10 minutes at 13,000 rpm. Reactions were removed andmixed 1:5 with TLC running buffer (1:1.5 (v/v) saturated NH4SO4 and 1.5MKH2PO4, pH 3.6) and spotted on PEIcellulose TLC plate (Sigma). Followingsolvent migration, the TLC plate was exposed to a phosphorimager screenand imaged using Typhoon scanner. For in vitro product transfection into293T cells, reactions were scaled up, radiolabeled nucleotide wasomitted and the concentration of ATP and GTP was increased to 2 mM.

I. Nuclease Digests

Nuclease P1 from Penicillium citrinum and Snake venom phosphodiesteraseI from Crotalus_adamanteus were purchased from Sigma. Reactions from invitro cyclic-di-nucleotide synthesis labeled with α32P-GTP were diluted1:5 in either P1 buffer (40 mM Tris-Cl, pH=6, 2 mM ZnCl2) or SVPD buffer(40 mM Tris-Cl, pH=8, mM MgCl2) followed by digestion with 2.5mU ofnuclease P1 or SVPD, respectively. Digestions were incubated for 45minutes at 37° C. and nucleotide products were resolved by TLC.

J. NMR Data

In the ¹H-³¹P HMBC spectrum shown in FIG. 6C, the phosphorous nucleus,P-11, is correlated to the 2′ ribose proton (H-12) of guanosine as wellas to the 5′ ribose methylene protons (H-10) and the 4′ ribose proton(H-9) of adenosine. The other phosphorous nucleus (P-22) is correlatedto the 3′ ribose proton (H-8) of adenosine as well as to the 5′ ribosemethylene protons (H-21) and 4′ ribose proton (H-20) of guanosine. Thus,the regiochemistry of the phosphodiester linkages was determined to becyclic[G(2′-5′)pA(3′-5′)p]. In order to assign the above peaks, it wascritical to accurately identify the ribose spin systems corresponding toguanosine and adenosine, respectively. The protons corresponding to theadenine nucleobase (H-2, H-5) and guanine nucleobase (H-17) wereassigned based upon reference spectra for the individual nucleobases,1H-13C HMBC, and 1H-13C HSQC NMR (FIG. 7A and 7B). The 1H-1H NOESYexperiment showed through-space interactions_between the adenine protonH-5 and the 3′ ribose proton (H-8) as well as between the guanine protonH-17 and the 1′ ribose proton (H-18) (FIG. 7D). The remaining protons inthe corresponding ribose spin systems were identified by 1H-1H COSY(FIG. 7C), and multiplicity edited 1H-13C HSQC (FIGS. 7A and 7B), whichdistinguished the 5′ methylene protons in particular (H-10 and H-21).

K. RNA, cDNA Synthesis, and Quantitative RT-PCR

RNA from mammalian cell lines was extracted using Trizol reagent(Invitrogen) or RNeasy Mini Kit (Qiagen). RNA was treated with RQ1RNase-free DNase (Promega). RNA was reverse transcribed with SuperscriptIII (Invitrogen). Mouse ifnB was quantified relative to mouse rps17 asdescribed previously (Woodward et al). Human ifnB was quantifiedrelative to human S9 as described previously (Wu et al).

The preceding merely illustrates the principles of the invention. Itwill be appreciated that those skilled in the art will be able to devisevarious arrangements which, although not explicitly described or shownherein, embody the principles of the invention and are included withinits spirit and scope. Furthermore, all examples and conditional languagerecited herein are principally intended to aid the reader inunderstanding the principles of the invention and the conceptscontributed by the inventors to furthering the art, and are to beconstrued as being without limitation to such specifically recitedexamples and conditions. Moreover, all statements herein recitingprinciples, aspects, and embodiments of the invention as well asspecific examples thereof, are intended to encompass both structural andfunctional equivalents thereof. Additionally, it is intended that suchequivalents include both currently known equivalents and equivalentsdeveloped in the future, i.e., any elements developed that perform thesame function, regardless of structure. The scope of the presentinvention, therefore, is not intended to be limited to the exemplaryembodiments shown and described herein. Rather, the scope and spirit ofthe present invention is embodied by the appended claims.

All publications and patent applications cited in this specification areherein incorporated by reference as if each individual publication orpatent application were specifically and individually indicated to beincorporated by reference. The citation of any publication is for itsdisclosure prior to the filing date and should not be construed as anadmission that the present invention is not entitled to antedate suchpublication by virtue of prior invention.

1. A method for increasing the production of a type I interferon (IFN)in a cell, the method comprising: increasing the level of a 2′-5′phosphodiester linkage comprising cyclic-di-nucleotide in the cell in amanner sufficient to increase production of the type I interferon (IFN)by the cell.
 2. The method according to claim 1, wherein the methodcomprises contacting the cell with the cyclic-di-nucleotide.
 3. Themethod according to claim 1, wherein the cyclic-di-nucleotide comprisesa two 2′-5′ phosphodiester linkage.
 4. The method according to claim 3,wherein the cyclic-di-nucleotide comprises a 2′5′ phosphodiester linkageand a 3′-5′ phosphodiester linkage.
 5. The method according to claim 1,wherein the cyclic-di-nucleotide comprises a guanosine nucleoside. 6.The method according to claim 5, wherein the cyclic-di-nucleotidecomprises two guanosine nucleosides.
 7. The method according to claim 1,wherein the cyclic-di-nucleotide comprises an adenosine nucleoside. 8.The method according to claim 7, wherein the cyclic-di-nucleotidecomprises two adenosine nucleosides.
 9. The method according to claim 1,wherein the cyclic-di-nucleotide comprises an adenosine nucleoside and aguanosine nucleoside.
 10. The method according to claim 1, wherein thecyclic-di-nucleotide is described by the formula:

wherein X and Y are each:


11. The method according to claim 10, wherein the cyclic-di-nucleotideis described by the formula:


12. The method according to claim 1, wherein the cyclic-di-nucleotide isdescribed by the formula:

wherein X and Y are each:


13. The method according to claim 1, wherein the level of thecyclic-di-nucleotide is increased by increasing the activity of a cGAMPsynthase (cGAS) in the cell. 14-15. (canceled)
 16. The method accordingto claim 1, wherein the IFN is interferon alpha.
 17. The methodaccording to claim 1, wherein the IFN is interferon beta.
 18. The methodaccording to claim 1, wherein the cell is a mammalian cell.
 19. Themethod according to claim 18, wherein the mammalian cell is a humancell. 20-21. (canceled)
 22. A method for increasing the production of atype I interferon (IFN) in a subject, the method comprising:administering to the subject an amount of a 2′-5′ phosphodiester linkagecomprising cyclic-di-nucleotide active agent effective to increase theproduction of the type I interferon in the subject. 23-42. (canceled)43. A cyclic-di-nucleotide comprising a 2′-5′ phosphodiester linkage.44-64. (canceled)
 65. A method for increasing a stimulator of interferongenes (STING) mediated response in a subject, the method comprising:administering to the subject an amount of a STING active agent effectiveto increase a STING 66-86. (canceled)